Prescribing Pattern of Antimicrobial Agents in the Post-operative General Surgery Ward of a Tertiary Care Teaching Hospital: A Prospective Observational Study

Background: This prospective observational study was done to know the current prescription trend of antimicrobial agents in the post-operative ward. To evaluate the current pattern of antimicrobial agents in the post-operative surgical cases of a tertiary care teaching hospital.

Aims: The present study was aimed to analyse the resistance pattern of culture isolates to antimicrobial agents in the post-operative general surgery cases. To assess the rationale for changing over from one antimicrobial agent to another.

Methods: The study was carried out in collaboration with the Department of General Surgery and Department of Pharmacology during April 2013 to March 2014. All parameters like demographic data, antimicrobials agents prescribed by surgeons, dose, frequency, duration, route, formulation, brand or generic drugs, adverse events were collected in the specially structured case proforma. Descriptive statistics was applied using SPSS version 17.0.

Results: During the study period, 513 patient case records were analysed in which males are higher than females. A total of 816 drugs were used in 484 patients during the study period. 162 were on a single drug, 190 were on two drugs, 42 were on three drugs and 90 were on fixed dose combination. Brand name of the drugs and parenteral route of administration were preferred in the study. Cephalosporins (52.32%) and metronidazole (34.38%) were the most commonly prescribed group of antimicrobials followed by penicillin (0.9%), aminoglycosides (6.58%), quinolones (5.23%), macrolides (0.45%) and tetracycline (0.14%). Totally 135 (27.89%) patients received drugs which are not included in the essential medicine list of WHO and 112 (23.14%) patients received drugs which are not from national EML.

Conclusions: The maximum prescribed antimicrobial agent in the post-operative ward was third generation cephalosporins. Rational prescribing of antibiotics would help avoid polypharmacy and prevent drug resistances. There is a clear need for the development of prescribing guidelines & educational initiatives to encourage the appropriate use of drugs in Surgery. Our study will help in promoting knowledge about essential medicine list among clinicians