A PROSPECTIVE STUDY OF THE IMPACT OF MICROBIOLOGICAL CULTURES ON ANTIBIOTIC PRESCRIBING PATTERN IN A TERTIARY CARE HOSPITAL
DOI:
https://doi.org/10.22159/ijpps.2021v13i3.40341Keywords:
Microbiological cultures, Antibiotic therapy, Prescribing pattern, Sensitivity resistance patternAbstract
Objective: Antibiotics are frequently prescribed because of clinical suspicion of infection, while the results of the microbiological analysis are still awaited. This study was undertaken to assess the impact of microbiological culture results on the antibiotic prescribing pattern.
Methods: This prospective observational study was conducted on 400 patients of either sex and any age with positive microbiological culture results. Empirical antibiotic therapy details were recorded and change in empirical antibiotic therapy after positive culture results was also recorded. Assessment of sensitivity resistance pattern of microorganisms was also performed.
Results: In the study, male: female ratio was 1.01:1. The majority of patients i.e. 94 (24.50%) were in the 46 y to 60 y of age group. Definitive antibiotic therapy was initiated in 103 patients (25.75%) out of 400 patients. The highest number of changes in antibiotic therapy was done in urinary tract infections (63.95%) and septicemia (32.61%) cases. Klebsiella (34.25%), E. coli (32%) and Staphylococcus aureus (14.75%) were commonly isolated microorganisms. Cephalosporins (77.75%) and aminoglycosides (47%) were commonly used in empirical antibiotic therapy, while nitrofurantoin (47.57%) and penicillins (22.33%) were commonly used in definitive antibiotic therapy. Definitive antibiotic therapy was associated with a reduced duration of hospital stay as compared to empirical antibiotic therapy (p<0.0001).
Conclusion: Antibiotic prescribing is infrequently influenced by microbiological culture results. Adjustment of the antimicrobial therapy according to microbiological culture results can decrease the duration of hospital stay as well as can decrease the spread of antimicrobial resistance.
Downloads
References
Goldman DA, Weinstein RA, Wenzel RP. Strategies to prevent and control the emergence and spread of antimicrobial-resistant microorganisms in hospitals. JAMA 1996;275:234–40.
Gross PA, Barrett TL, Patchen DE. Quality standard for the treatment of bacteremia. Clin Infect Dis 1994;18:428–30.
Evans RS, Classen DC, Pestontik SL, Lundsgaarde HP, Burke JP. Improving empiric antibiotic selection using computer decision support. Arch Intern Med 1994;154:878–84.
John JF Jr, Fishman NO. Programmatic role of the infectious diseases physician in controlling antimicrobial costs in the hospital. Clin Infect Dis 1997;24:471–85.
Chiu J, Thompson GW, Austin TW, Hussain Z, John M, Bombassaro AM, et al. Antibiotic prescribing practices for catheter urine culture results. Can J Hosp Pharm 2013;66:13-20.
Berild D, Ringertz SH, Lelek M. Appropriate antibiotic use according to diagnoses and bacteriological findings: report of 12 point-prevalence studies on antibiotic use in a university hospital. Scand J Infect Dis 2002;34:56-60.
Arbo MDJ, Snydman DR. Influence of blood culture results on antibiotic choice in the treatment of bacteremia. Arch Intern Med 1994;154:2641–5.
Maraha B, Bonten M, Fiolet H, Stobberingh E. The impact of microbiological cultures on antibiotic prescribing in general internal medicine wards: microbiological evaluation and antibiotic use. Clin Microbiol Infect 2000:6:99-102.
Gyssens IC. Optimizing antimicrobial drug utilization. Studies and interventions in a University hospital. Ph. D. Thesis, the Netherlands: Catholic University of Nijmegen; 1996. p. 127–65.
Moss F, McNicol MW, McSwiggan DA, Miller DL. Survey of antibiotic prescribing in a district general hospital. I Pattern of use. Lancet 1981;ii:349–52.
Shalini D, Joshi MC, Rashid MK, Joshi HS. Study of antibiotic sensitivity pattern in urinary tract infection at a tertiary hospital. Natl J Integr Res Med 2011;2:43-6.
Duran N, Ozer B, Duran G, Onlen Y, Demir C. Antibiotic resistance genes and susceptibility patterns in staphylococci. Indian J Med Res 2012;135:389-96.
World health organization. Prevention of hospital acquired infections. Available from: http://www.who.int/csr/ resources/ publications/whocdscsreph200212.pdf [Last accessed on 06 Aug 2015].
SARI. A strategy for the control of antimicrobial resistance in Ireland. Available from: https://www.hpsc.ie/A-Z/MicrobiologyAntimicrobialResistance/InfectionControlandHAI/Guidelines/File,4116,en.pdf [Last accessed on 06 Aug 2015]
Berlid D, Mohseni A, Diep ML, Jensenius M, Ringertz SH. Adjustment of antibiotic treatment according to results of blood culture leads to decrease antibiotic use and costs. J Antimicrob Chemother 2006;57:326-30.
Mistry VR, Pandya AS, Chaudhari JS, Sondarva DB, Pillai A, Hotchandani SC. Use of antimicrobial prophylaxis in clean elective orthopedic surgical procedures and identifying common infective organisms. Int J Med Sci Public Health 2013;2:994-1000.
Nathwani D, Davey P, France AJ, Phillips G, Orange G, Parratt D. Impact of an infection consultation service for bacteraemia on clinical management and use of resources. Q J Med 1996;89:789–97.
Byl B, Clevenbergh P, Jacobs F, Struelens MJ, Zech F, Kentos A, et al. Impact of infectious disease specialists and microbiological data on the appropriateness of antimicrobial therapy for bacteremia. Clin Infect Dis 1999;29:60-6.
Laxminarayan R, Duse A, Wattal C, Zaidi AKM, Wertheim HFL, Sumpradit N, et al. Antibiotic resistance-the need for global solutions. Lancet Infect Dis 2013;13:1057-98.
Published
How to Cite
Issue
Section
