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Antibiotic prescribing among patients with severe infectious diseases in two private sector hospitals in Central India – a time series analysis over 10 years
BACKGROUND: Antibiotic resistance is an emerging problem caused due to antibiotic use. In countries with high rates of infectious diseases, antibiotic resistance is a frequent cause of mortality. The aim was to analyse antibiotic prescribing practices between 2008 and 2017 in a teaching (TH) and a n...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218632/ https://www.ncbi.nlm.nih.gov/pubmed/32404055 http://dx.doi.org/10.1186/s12879-020-05059-7 |
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author | Damlin, Anna Sharma, Megha Marrone, Gaetano Stålsby Lundborg, Cecilia |
author_facet | Damlin, Anna Sharma, Megha Marrone, Gaetano Stålsby Lundborg, Cecilia |
author_sort | Damlin, Anna |
collection | PubMed |
description | BACKGROUND: Antibiotic resistance is an emerging problem caused due to antibiotic use. In countries with high rates of infectious diseases, antibiotic resistance is a frequent cause of mortality. The aim was to analyse antibiotic prescribing practices between 2008 and 2017 in a teaching (TH) and a non-teaching (NTH) hospital, as typical hospitals of low- and middle-income countries, and to compare antibiotic prescribing for severe infectious indications for which empiric antibiotic treatment is recommended. METHODS: Data from adult patients registered at two Indian private-sector hospitals with one of the following indications: epiglottitis, pneumonia, peritonitis, pyelonephritis, cellulitis, erysipelas, septic arthritis, endocarditis, meningitis or sepsis; were included and analysed. Antibiotic prescription data was analyzed using the World Health Organization’s (WHO) Anatomical Therapeutic Chemical classification system and the Defined Daily Doses. Chi-square and linear regression were used to compare the data between groups. Time series analyses were conducted using linear regression. P-values < 0.05 were considered significant. RESULTS: In total, 3766 patients were included, 2504 inpatients in the NTH and 1262 in the TH, of which 92 and 89% patients, respectively, were prescribed antibiotics. Sixty-one percent of total prescriptions in the TH and 40% in the NTH comprised the access category of antibiotics (i.e. the first-choice of treatment according to the WHO). The WHO’s second-choice of treatment, the watch category, comprised 29 and 40% of total prescriptions in the TH and NTH, respectively. Prescribing of fixed-dose combinations (FDCs) of antibiotics was significantly higher in the NTH (18%) than in the TH (8%, P < 0.05). Prescribing of watch antibiotics and FDCs increased significantly in both hospitals between 2008 and 2017 among patients with pneumonia, cellulitis and peritonitis (P < 0.05). CONCLUSIONS: Prescribing of watch antibiotics and FDCs of antibiotics increased over time at both hospitals, indicating under prescribing of access antibiotics and more prescribing of second-choice antibiotics. The results can be used to highlight the areas of improvement in similar settings. Implementing diagnostic routines and local prescribing guidelines could improve the prescribing practices. |
format | Online Article Text |
id | pubmed-7218632 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-72186322020-05-20 Antibiotic prescribing among patients with severe infectious diseases in two private sector hospitals in Central India – a time series analysis over 10 years Damlin, Anna Sharma, Megha Marrone, Gaetano Stålsby Lundborg, Cecilia BMC Infect Dis Research Article BACKGROUND: Antibiotic resistance is an emerging problem caused due to antibiotic use. In countries with high rates of infectious diseases, antibiotic resistance is a frequent cause of mortality. The aim was to analyse antibiotic prescribing practices between 2008 and 2017 in a teaching (TH) and a non-teaching (NTH) hospital, as typical hospitals of low- and middle-income countries, and to compare antibiotic prescribing for severe infectious indications for which empiric antibiotic treatment is recommended. METHODS: Data from adult patients registered at two Indian private-sector hospitals with one of the following indications: epiglottitis, pneumonia, peritonitis, pyelonephritis, cellulitis, erysipelas, septic arthritis, endocarditis, meningitis or sepsis; were included and analysed. Antibiotic prescription data was analyzed using the World Health Organization’s (WHO) Anatomical Therapeutic Chemical classification system and the Defined Daily Doses. Chi-square and linear regression were used to compare the data between groups. Time series analyses were conducted using linear regression. P-values < 0.05 were considered significant. RESULTS: In total, 3766 patients were included, 2504 inpatients in the NTH and 1262 in the TH, of which 92 and 89% patients, respectively, were prescribed antibiotics. Sixty-one percent of total prescriptions in the TH and 40% in the NTH comprised the access category of antibiotics (i.e. the first-choice of treatment according to the WHO). The WHO’s second-choice of treatment, the watch category, comprised 29 and 40% of total prescriptions in the TH and NTH, respectively. Prescribing of fixed-dose combinations (FDCs) of antibiotics was significantly higher in the NTH (18%) than in the TH (8%, P < 0.05). Prescribing of watch antibiotics and FDCs increased significantly in both hospitals between 2008 and 2017 among patients with pneumonia, cellulitis and peritonitis (P < 0.05). CONCLUSIONS: Prescribing of watch antibiotics and FDCs of antibiotics increased over time at both hospitals, indicating under prescribing of access antibiotics and more prescribing of second-choice antibiotics. The results can be used to highlight the areas of improvement in similar settings. Implementing diagnostic routines and local prescribing guidelines could improve the prescribing practices. BioMed Central 2020-05-13 /pmc/articles/PMC7218632/ /pubmed/32404055 http://dx.doi.org/10.1186/s12879-020-05059-7 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Damlin, Anna Sharma, Megha Marrone, Gaetano Stålsby Lundborg, Cecilia Antibiotic prescribing among patients with severe infectious diseases in two private sector hospitals in Central India – a time series analysis over 10 years |
title | Antibiotic prescribing among patients with severe infectious diseases in two private sector hospitals in Central India – a time series analysis over 10 years |
title_full | Antibiotic prescribing among patients with severe infectious diseases in two private sector hospitals in Central India – a time series analysis over 10 years |
title_fullStr | Antibiotic prescribing among patients with severe infectious diseases in two private sector hospitals in Central India – a time series analysis over 10 years |
title_full_unstemmed | Antibiotic prescribing among patients with severe infectious diseases in two private sector hospitals in Central India – a time series analysis over 10 years |
title_short | Antibiotic prescribing among patients with severe infectious diseases in two private sector hospitals in Central India – a time series analysis over 10 years |
title_sort | antibiotic prescribing among patients with severe infectious diseases in two private sector hospitals in central india – a time series analysis over 10 years |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218632/ https://www.ncbi.nlm.nih.gov/pubmed/32404055 http://dx.doi.org/10.1186/s12879-020-05059-7 |
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