Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan: a longitudinal surveillance and implications
Abstract Background The inappropriate use of antibiotics in hospitals increases resistance, morbidity, and mortality. Little is currently known about appropriate antibiotic use among hospitals in Lahore, the capital city of Pakistan. Methods Longitudinal surveillance was conducted over a period of 2...
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | Antimicrobial Resistance and Infection Control |
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| Online Access: | http://link.springer.com/article/10.1186/s13756-019-0649-5 |
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| author | Zikria Saleem Hamid Saeed Mohamed Azmi Hassali Brian Godman Usama Asif Mahrukh Yousaf Zakiuddin Ahmed Humayun Riaz Syed Atif Raza |
| author_facet | Zikria Saleem Hamid Saeed Mohamed Azmi Hassali Brian Godman Usama Asif Mahrukh Yousaf Zakiuddin Ahmed Humayun Riaz Syed Atif Raza |
| author_sort | Zikria Saleem |
| collection | DOAJ |
| description | Abstract Background The inappropriate use of antibiotics in hospitals increases resistance, morbidity, and mortality. Little is currently known about appropriate antibiotic use among hospitals in Lahore, the capital city of Pakistan. Methods Longitudinal surveillance was conducted over a period of 2 months among hospitals in Lahore, Pakistan. Antibiotic treatment was considered inappropriate on the basis of a wrong dosage regimen, wrong indication, or both based on the British National Formulary. Results A total of 2022 antibiotics were given to 1185 patients. Out of the total prescribed, approximately two-thirds of the study population (70.3%) had at least one inappropriate antimicrobial. Overall, 27.2% of patients had respiratory tract infections, and out of these, 62.8% were considered as having inappropriate therapy. Cephalosporins were extensively prescribed among patients, and in many cases, this was inappropriate (67.2%). Penicillins were given to 283 patients, out of which 201 (71.0%) were prescribed for either the wrong indication or dosage or both. Significant variations were also observed regarding inappropriate prescribing for several antimicrobials including the carbapenems (70.9%), aminoglycosides (35.8%), fluoroquinolones (64.2%), macrolides (74.6%) and other antibacterials (73.1%). Conclusion Educational interventions, institutional guidelines, and antimicrobial stewardship programs need to be developed to enhance future appropriate antimicrobial use in hospitals in Pakistan. Policies by healthcare and Government officials are also needed to minimize inappropriate antibiotic use. |
| first_indexed | 2024-12-13T05:40:21Z |
| format | Article |
| id | doaj.art-f69e259e2f824d88ae8495d4e0576144 |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-13T05:40:21Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-f69e259e2f824d88ae8495d4e05761442022-12-21T23:57:49ZengBMCAntimicrobial Resistance and Infection Control2047-29942019-11-01811710.1186/s13756-019-0649-5Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan: a longitudinal surveillance and implicationsZikria Saleem0Hamid Saeed1Mohamed Azmi Hassali2Brian Godman3Usama Asif4Mahrukh Yousaf5Zakiuddin Ahmed6Humayun Riaz7Syed Atif Raza8School of Pharmaceutical Sciences, Universiti Sains MalaysiaUniversity College of Pharmacy, University of the PunjabSchool of Pharmaceutical Sciences, Universiti Sains MalaysiaSchool of Pharmaceutical Sciences, Universiti Sains MalaysiaMedical Centre, Agha Khan University HospitalMedical Centre, Agha Khan University HospitalRipha Institute of Healthcare Improvement & Safety, Ripha UniversityRashid Latif College of PharmacyUniversity College of Pharmacy, University of the PunjabAbstract Background The inappropriate use of antibiotics in hospitals increases resistance, morbidity, and mortality. Little is currently known about appropriate antibiotic use among hospitals in Lahore, the capital city of Pakistan. Methods Longitudinal surveillance was conducted over a period of 2 months among hospitals in Lahore, Pakistan. Antibiotic treatment was considered inappropriate on the basis of a wrong dosage regimen, wrong indication, or both based on the British National Formulary. Results A total of 2022 antibiotics were given to 1185 patients. Out of the total prescribed, approximately two-thirds of the study population (70.3%) had at least one inappropriate antimicrobial. Overall, 27.2% of patients had respiratory tract infections, and out of these, 62.8% were considered as having inappropriate therapy. Cephalosporins were extensively prescribed among patients, and in many cases, this was inappropriate (67.2%). Penicillins were given to 283 patients, out of which 201 (71.0%) were prescribed for either the wrong indication or dosage or both. Significant variations were also observed regarding inappropriate prescribing for several antimicrobials including the carbapenems (70.9%), aminoglycosides (35.8%), fluoroquinolones (64.2%), macrolides (74.6%) and other antibacterials (73.1%). Conclusion Educational interventions, institutional guidelines, and antimicrobial stewardship programs need to be developed to enhance future appropriate antimicrobial use in hospitals in Pakistan. Policies by healthcare and Government officials are also needed to minimize inappropriate antibiotic use.http://link.springer.com/article/10.1186/s13756-019-0649-5AppropriatenessAntibiotics, hospitalsPrescribingPakistan |
| spellingShingle | Zikria Saleem Hamid Saeed Mohamed Azmi Hassali Brian Godman Usama Asif Mahrukh Yousaf Zakiuddin Ahmed Humayun Riaz Syed Atif Raza Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan: a longitudinal surveillance and implications Antimicrobial Resistance and Infection Control Appropriateness Antibiotics, hospitals Prescribing Pakistan |
| title | Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan: a longitudinal surveillance and implications |
| title_full | Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan: a longitudinal surveillance and implications |
| title_fullStr | Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan: a longitudinal surveillance and implications |
| title_full_unstemmed | Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan: a longitudinal surveillance and implications |
| title_short | Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan: a longitudinal surveillance and implications |
| title_sort | pattern of inappropriate antibiotic use among hospitalized patients in pakistan a longitudinal surveillance and implications |
| topic | Appropriateness Antibiotics, hospitals Prescribing Pakistan |
| url | http://link.springer.com/article/10.1186/s13756-019-0649-5 |
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