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Published in: Antimicrobial Resistance & Infection Control 1/2019

Open Access 01-12-2019 | Antibiotic | Research

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

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

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2019

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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 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.
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Metadata
Title
Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan: a longitudinal surveillance and implications
Authors
Zikria Saleem
Hamid Saeed
Mohamed Azmi Hassali
Brian Godman
Usama Asif
Mahrukh Yousaf
Zakiuddin Ahmed
Humayun Riaz
Syed Atif Raza
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Antimicrobial Resistance & Infection Control / Issue 1/2019
Electronic ISSN: 2047-2994
DOI
https://doi.org/10.1186/s13756-019-0649-5

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