Prescription trends and antibiotic utilization in pneumonia: an observational study at a tertiary teaching hospital

Sai Sowmya Bhupathiraju1, Latha Maregouda Goudar1, Srujan Manjunath1

  • 1Department of Pharmacy Practice, KLE College of Pharmacy, Vidyanagar, Hubballi, Karnataka.

Insights

This study found widespread antibiotic overuse and polypharmacy in pneumonia treatment, with azithromycin being the most prescribed. Optimizing antibiotic selection and implementing stewardship programs are crucial to combat antimicrobial resistance (AMR).

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Public Health

Background:

  • Pneumonia poses a significant global health burden, especially in vulnerable populations.
  • Rational antibiotic selection is critical to improve treatment outcomes and combat antimicrobial resistance (AMR).

Purpose of the Study:

  • To analyze antibiotic prescribing patterns and utilization trends in pneumonia patients.
  • To identify areas for improvement in antibiotic therapy to mitigate AMR.

Main Methods:

  • Prospective observational study of 200 pneumonia patients at Vivekananda Hospital, India.
  • Data collection included demographics, lab values, and prescription patterns.
  • Analysis using descriptive statistics and World Health Organization prescribing indicators.

Main Results:

  • All prescriptions included at least one antibiotic, with 28.51% of drugs being antibiotics.
  • High prevalence of polypharmacy, with most prescriptions containing multiple antibiotics.
  • Azithromycin was the most prescribed antibiotic, showing potential overuse (9.85 DDD/1000/days).

Conclusions:

  • Urgent need to improve rational antibiotic prescribing, including generic use and culture sensitivity testing.
  • Implementation of an Antimicrobial Stewardship Program is essential to optimize antibiotic use and reduce AMR development.

Related Concept Videos

Pneumonia I: Introduction01:30

Pneumonia I: Introduction

Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Pneumonia III: Complications and Assessment01:30

Pneumonia III: Complications and Assessment

Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
Pneumonia IV: Management01:28

Pneumonia IV: Management

The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Pneumonia V: Nursing management and Prevention01:30

Pneumonia V: Nursing management and Prevention

Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Atypical Pneumonia01:14

Atypical Pneumonia

Atypical pneumonia, often caused by Mycoplasma pneumoniae, is a form of pulmonary infection that differs from the classical presentation of bacterial pneumonia in both its cause and clinical symptoms. Mycoplasma pneumoniae is a pleomorphic bacterium notable for its lack of a rigid cell wall. This structural characteristic imparts resistance to beta-lactam antibiotics and significantly influences the bacterium’s behavior within the human host.Other pathogens responsible for the disease include...