A Cross Sectional Study of Antibiotic Usage in a Tertiary Care Hospital and Health Center in a North Maharashtra District

Introduction: Appropriate use of antibiotics is important for (a) Better therapeutic results (b) Saving costs (c) Minimize resistance to antibiotics. This is a descriptive cross-sectional study of pre- scriptions in a tertiary hospital and health center. Objective was to evaluate antibiotic usage in a teaching institute. Methodology: For a sample size of 220, 256 prescriptions from IPD and OPD, containing any antimicrobial, at the pharmacy and an- other 240 prescriptions from the peripheral Health Centre were collected over a fortnight in 2018. Prescriber identity was con- cealed and protected. Prescriptions were assessed by two inde- pendent raters based on the AMR National Guidelines on antibiot- ics. Rater 1 and Rater2 had fair agreement (quadratic kappa 0.3348, 95%CI 0.2207-0.4489). Data were compiled and analyzed on excel and EPI info. Results: Hospital pool yielded 203 medical and 53 surgical cases, of which 60% prescriptions were rated appropriate, 35% border- line and 5% un-acceptable. Health center data (n=240) showed 89% had no diagnosis. Amoxicillin+Clavulinic acid, ceftriaxone, azithromycin, Ofloxacin topped the hospital usage, while Amox+CA and Cefixime topped the health center usage. Conclusions: Hospital prescriptions nearly conformed to guide- lines, the Health center prescribing called for adherence to proto- cols. Cost –reducing options and minimizing resistance to higher antibiotics.