Antimicrobial prescribing patterns of surgical speciality in a tertiary care hospital in India: Role of persuasive intervention for changing antibiotic prescription behaviour

Indian J Med Microbiol. 2017 Jul-Sep;35(3):369-375. doi: 10.4103/ijmm.IJMM_17_273.

Abstract

Background: Inappropriate use of antibiotics globally has been linked to increase in antibiotic resistance.

Objectives: This interventional study assessed the impact of antibiotic prescription feedback and focus group discussions (FGD) on hospital-based prescribers before and after the FGD.

Study design: The present study was performed at a tertiary care centre in New Delhi, wherein 45 units from surgical specialities were included for FGD. Thirty-five units were assessed for the antibiotic usage during 12 months pre-intervention and 3 and 6 months post-intervention period. The outcome measured was a change in antibiotic prescription rates reflected as daily defined doses per 100 bed days as defined by the World Health Organisation.

Results: Reduction in the level of antibiotic consumption was observed in 15 of 35 units (42.85%) during the 3 months post-intervention period, which was significant (P < 0.05) in 3/35 (8.57%) surgical units. A significant reduction (P < 0.05) was observed for the units of endoscopic gynaecology, super-speciality and transplant surgery units B and C, and orthopaedic unit C during the 6 months period. Decreasing trend (P < 0.05) was observed in 2/35 (5.71%) units during the entire period. Overall reduction of antibiotic consumption (1.88%) was observed, with an increase in the use of low-end antibiotics and a decrease in the use of high-end antibiotics.

Conclusion: The present study clearly demonstrates a weak impact of FGD in changing antibiotic prescribing behaviour. Further analysis of the sustainability of FGD and its long-term impact on antimicrobial resistance needs to be evaluated. The effect of continuous educational sessions and multifaceted interventions cannot be ignored.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Behavior Therapy
  • Drug Utilization*
  • Health Services Research
  • Humans
  • India
  • Practice Patterns, Physicians'*
  • Prescriptions / standards*
  • Surgery Department, Hospital*
  • Tertiary Care Centers*

Substances

  • Anti-Bacterial Agents