Antimicrobial Prescribing Patterns of Surgical Speciality in a Tertiary Care Hospital in India: Role of Persuasive Intervention for Changing Antibiotic Prescription Behaviour

• Published in: Indian journal of medical microbiology Vol. 35; no. 3; pp. 369 - 375
• Main Authors: Wattal, Chand, Khanna, Shilpi, Goel, Neeraj, Oberoi, Jaswinder Kaur, Rao, B.K.
• Format: Journal Article
• Language: English
• Published: India Elsevier B.V 01.07.2017; Elsevier Limited
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibiotic resistance; Antibiotics; Antiinfectives and antibacterials; Antimicrobial agents; Antimicrobial resistance; Antimicrobial stewardship; Behavior Therapy; Drug Utilization; Feedback; Gastrointestinal surgery; Health Services Research; Hospitals; Humans; Immunology; India; Intervention; persuasive intervention; Practice Patterns, Physicians; Prescriptions - standards; Reduction; Regression analysis; Surgery; Surgery Department, Hospital; surgical specialities; Sustainability; Tertiary Care Centers; Thoracic surgery; Time series; Trends; India; surgical specialities; Antimicrobial stewardship; persuasive intervention
• ISSN: 0255-0857; 1998-3646
• DOI: 10.4103/ijmm.IJMM_17_273

Background: Inappropriate use of antibiotics globally has been linked to increase in antibiotic resistance. Objectives: This interventional study assessed the impact of antibiotic prescription feedback and focus group discussions (FGD) on hospital-based prescribers before and after the FGD. Study Design: The present study was performed at a tertiary care centre in New Delhi, wherein 45 units from surgical specialities were included for FGD. Thirty-five units were assessed for the antibiotic usage during 12 months pre-intervention and 3 and 6 months post-intervention period. The outcome measured was a change in antibiotic prescription rates reflected as daily defined doses per 100 bed days as defined by the World Health Organisation. Results: Reduction in the level of antibiotic consumption was observed in 15 of 35 units (42.85%) during the 3 months post-intervention period, which was significant (P < 0.05) in 3/35 (8.57%) surgical units. A significant reduction (P < 0.05) was observed for the units of endoscopic gynaecology, super-speciality and transplant surgery units B and C, and orthopaedic unit C during the 6 months period. Decreasing trend (P < 0.05) was observed in 2/35 (5.71%) units during the entire period. Overall reduction of antibiotic consumption (1.88%) was observed, with an increase in the use of low-end antibiotics and a decrease in the use of high-end antibiotics. Conclusion: The present study clearly demonstrates a weak impact of FGD in changing antibiotic prescribing behaviour. Further analysis of the sustainability of FGD and its long-term impact on antimicrobial resistance needs to be evaluated. The effect of continuous educational sessions and multifaceted interventions cannot be ignored.