Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan: a longitudinal surveillance and implications

Zikria Saleem, Hamid Saeed, Mohamed Azmi Ahmad Hassali, Brian Godman, Usama Asif, Mahrukh Yousaf, Zakiuddin Ahmed, Humayun Riaz, Syed Atif Raza

Research output: Contribution to journalArticle

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 two 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.
LanguageEnglish
Article number188
Number of pages10
JournalAntimicrobial Resistance and Infection Control
Volume8
Publication statusPublished - 21 Nov 2019

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Pakistan
Anti-Bacterial Agents
Inappropriate Prescribing
Carbapenems
Pharmacopoeias
Fluoroquinolones
Macrolides
Aminoglycosides
Cephalosporins
Respiratory Tract Infections
Penicillins
Guidelines
Morbidity
Delivery of Health Care
Mortality
Therapeutics
Population

Keywords

  • antibiotics
  • prescribing behaviour
  • hospitals
  • Pakistan

Cite this

Saleem, Zikria ; Saeed, Hamid ; Hassali, Mohamed Azmi Ahmad ; Godman, Brian ; Asif, Usama ; Yousaf, Mahrukh ; Ahmed, Zakiuddin ; Riaz, Humayun ; Raza, Syed Atif . / Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan : a longitudinal surveillance and implications. In: Antimicrobial Resistance and Infection Control. 2019 ; Vol. 8.
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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 two 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.",
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Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan : a longitudinal surveillance and implications. / Saleem, Zikria ; Saeed, Hamid ; Hassali, Mohamed Azmi Ahmad; Godman, Brian; Asif, Usama; Yousaf, Mahrukh ; Ahmed, Zakiuddin; Riaz, Humayun ; Raza, Syed Atif .

In: Antimicrobial Resistance and Infection Control, Vol. 8, 188, 21.11.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan

T2 - Antimicrobial Resistance and Infection Control

AU - Saleem, Zikria

AU - Saeed, Hamid

AU - Hassali, Mohamed Azmi Ahmad

AU - Godman, Brian

AU - Asif, Usama

AU - Yousaf, Mahrukh

AU - Ahmed, Zakiuddin

AU - Riaz, Humayun

AU - Raza, Syed Atif

PY - 2019/11/21

Y1 - 2019/11/21

N2 - 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 two 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.

AB - 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 two 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.

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SN - 2047-2994

M1 - 188

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