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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.
Abstract:
Pneumonia is a significant cause of morbidity and mortality, particularly among 5-year-olds, the elderly population, and those with comorbid conditions. As antibiotics are the most commonly used drugs, they need to be selected rationally to improve the therapeutic outcomes as well as to limit the emergence of antimicrobial resistance (AMR). This prospective observational study was carried out at Vivekananda Hospital, Hubballi, Karnataka, India, from October 2024 to March 2025. The data, such as demographics, laboratory values, patterns of prescription, and utilization trends from 200 study subjects, were collected, analyzed, and statistically tested using descriptive analysis. The World Health Organization core drug prescribing indicators revealed an average of 9775 drugs per prescription, of which antibiotics constitute 28.51%, with all prescriptions containing at least one antibiotic. Also, there is a high prevalence of polypharmacy, with the majority of prescriptions containing two or more antibiotics. The most commonly prescribed antibiotic was azithromycin, followed by ceftriaxone and piperacillin + tazobactam and the highest defined daily dose (DDD)/1000/days was observed in azithromycin (9.85), indicating potential overuse, whereas linezolid and cefixime had a prescriber daily dose value equal to DDD. The study emphasizes the need for improvement in generic prescribing, including the use of culture sensitivity tests for selection of appropriate antibiotics and implementation of an Antimicrobial Stewardship Program to optimize the antibiotic use and minimize the development of AMR.
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