Point Prevalence Study (PPS) of Antibiotic Usage and Bacterial Culture Rate (BCR) among Secondary Care Hospitals of Small Cities in Central India: Consolidating Indian Evidence
Indian hospitals (especially government-run public sector hospitals) have a nonexistent antimicrobial stewardship program (AMSP). After successfully initiating AMSPs in tertiary care hospitals of India, the Indian Council of Medical Research envisages implementing AMSP in secondary care hospitals. T...
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| Published in | Journal of laboratory physicians Vol. 15; no. 2; pp. 259 - 263 |
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| Main Authors | , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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Germany
Thieme Medical and Scientific Publishers Pvt. Ltd
01.06.2023
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| Abstract | Indian hospitals (especially government-run public sector hospitals) have a nonexistent antimicrobial stewardship program (AMSP). After successfully initiating AMSPs in tertiary care hospitals of India, the Indian Council of Medical Research envisages implementing AMSP in secondary care hospitals. This study is about the baseline data on antibiotic consumption in secondary care hospitals.
It was a prospective longitudinal observational chart review type of study. Baseline data on antibiotic consumption was captured by a 24-hour point prevalence study of antibiotic usage and bacterial culture rate. The prescribed antibiotics were classified according to the World Health Organization (WHO) Access, Watch, and Reserve classification. All data were collated in Microsoft Excel and summarized as percentages.
Out of the 864 patients surveyed, overall antibiotic usage was 78.9% (71.5% in low-priority areas vs. 92.2% in high-priority areas). Most of the antibiotic usage was empirical with an extremely low bacterial culture rate (21.9%). Out of the prescribed drugs, 53.1% were from the WHO watch category and 5.5% from the reserve category.
Even after 5 years of the launch of the national action plan on AMR (NAP-AMR) of India, AMSP is still non-existent in small- and medium-level hospitals in urban cities. The importance of trained microbiologists in the health care system is identified as a fulcrum in combating antimicrobial resistance (AMR); however, their absence in government-run district hospitals is a matter of grave concern and needs to be addressed sooner than later. |
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| AbstractList | Objective
Indian hospitals (especially government-run public sector hospitals) have a nonexistent antimicrobial stewardship program (AMSP). After successfully initiating AMSPs in tertiary care hospitals of India, the Indian Council of Medical Research envisages implementing AMSP in secondary care hospitals. This study is about the baseline data on antibiotic consumption in secondary care hospitals.
Materials and Methods
It was a prospective longitudinal observational chart review type of study. Baseline data on antibiotic consumption was captured by a 24-hour point prevalence study of antibiotic usage and bacterial culture rate. The prescribed antibiotics were classified according to the World Health Organization (WHO) Access, Watch, and Reserve classification. All data were collated in Microsoft Excel and summarized as percentages.
Results
Out of the 864 patients surveyed, overall antibiotic usage was 78.9% (71.5% in low-priority areas vs. 92.2% in high-priority areas). Most of the antibiotic usage was empirical with an extremely low bacterial culture rate (21.9%). Out of the prescribed drugs, 53.1% were from the WHO watch category and 5.5% from the reserve category.
Conclusion
Even after 5 years of the launch of the national action plan on AMR (NAP-AMR) of India, AMSP is still non-existent in small- and medium-level hospitals in urban cities. The importance of trained microbiologists in the health care system is identified as a fulcrum in combating antimicrobial resistance (AMR); however, their absence in government-run district hospitals is a matter of grave concern and needs to be addressed sooner than later. Abstract Objective Indian hospitals (especially government-run public sector hospitals) have a nonexistent antimicrobial stewardship program (AMSP). After successfully initiating AMSPs in tertiary care hospitals of India, the Indian Council of Medical Research envisages implementing AMSP in secondary care hospitals. This study is about the baseline data on antibiotic consumption in secondary care hospitals. Materials and Methods It was a prospective longitudinal observational chart review type of study. Baseline data on antibiotic consumption was captured by a 24-hour point prevalence study of antibiotic usage and bacterial culture rate. The prescribed antibiotics were classified according to the World Health Organization (WHO) Access, Watch, and Reserve classification. All data were collated in Microsoft Excel and summarized as percentages. Results Out of the 864 patients surveyed, overall antibiotic usage was 78.9% (71.5% in low-priority areas vs. 92.2% in high-priority areas). Most of the antibiotic usage was empirical with an extremely low bacterial culture rate (21.9%). Out of the prescribed drugs, 53.1% were from the WHO watch category and 5.5% from the reserve category. Conclusion Even after 5 years of the launch of the national action plan on AMR (NAP-AMR) of India, AMSP is still non-existent in small- and medium-level hospitals in urban cities. The importance of trained microbiologists in the health care system is identified as a fulcrum in combating antimicrobial resistance (AMR); however, their absence in government-run district hospitals is a matter of grave concern and needs to be addressed sooner than later. Objective Indian hospitals (especially government-run public sector hospitals) have a nonexistent antimicrobial stewardship program (AMSP). After successfully initiating AMSPs in tertiary care hospitals of India, the Indian Council of Medical Research envisages implementing AMSP in secondary care hospitals. This study is about the baseline data on antibiotic consumption in secondary care hospitals. Materials and Methods It was a prospective longitudinal observational chart review type of study. Baseline data on antibiotic consumption was captured by a 24-hour point prevalence study of antibiotic usage and bacterial culture rate. The prescribed antibiotics were classified according to the World Health Organization (WHO) Access, Watch, and Reserve classification. All data were collated in Microsoft Excel and summarized as percentages. Results Out of the 864 patients surveyed, overall antibiotic usage was 78.9% (71.5% in low-priority areas vs. 92.2% in high-priority areas). Most of the antibiotic usage was empirical with an extremely low bacterial culture rate (21.9%). Out of the prescribed drugs, 53.1% were from the WHO watch category and 5.5% from the reserve category. Conclusion Even after 5 years of the launch of the national action plan on AMR (NAP-AMR) of India, AMSP is still non-existent in small- and medium-level hospitals in urban cities. The importance of trained microbiologists in the health care system is identified as a fulcrum in combating antimicrobial resistance (AMR); however, their absence in government-run district hospitals is a matter of grave concern and needs to be addressed sooner than later. Indian hospitals (especially government-run public sector hospitals) have a nonexistent antimicrobial stewardship program (AMSP). After successfully initiating AMSPs in tertiary care hospitals of India, the Indian Council of Medical Research envisages implementing AMSP in secondary care hospitals. This study is about the baseline data on antibiotic consumption in secondary care hospitals. It was a prospective longitudinal observational chart review type of study. Baseline data on antibiotic consumption was captured by a 24-hour point prevalence study of antibiotic usage and bacterial culture rate. The prescribed antibiotics were classified according to the World Health Organization (WHO) Access, Watch, and Reserve classification. All data were collated in Microsoft Excel and summarized as percentages. Out of the 864 patients surveyed, overall antibiotic usage was 78.9% (71.5% in low-priority areas vs. 92.2% in high-priority areas). Most of the antibiotic usage was empirical with an extremely low bacterial culture rate (21.9%). Out of the prescribed drugs, 53.1% were from the WHO watch category and 5.5% from the reserve category. Even after 5 years of the launch of the national action plan on AMR (NAP-AMR) of India, AMSP is still non-existent in small- and medium-level hospitals in urban cities. The importance of trained microbiologists in the health care system is identified as a fulcrum in combating antimicrobial resistance (AMR); however, their absence in government-run district hospitals is a matter of grave concern and needs to be addressed sooner than later. |
| Author | Biswal, DebaDulal Srivastava, Rakesh Khadanga, Sagar Baharani, Deepak Pansey, Parijat Mishra, Vivek Gupta, Ankur Chandiwal, Sunil Rajpoot, Shailendra Singh Gupta, Amit Karuna, Tadepalli Gupta, Ayush Shrivastava, Sandeep Shukla, Pankaj Kumar, Shweta Ansari, Mehrunnisa Walia, Kamini Goel, Pramod |
| AuthorAffiliation | 1 Department of General Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India 12 Department of Medical Oncology, Balco Medical Centre, Raipur, Chhattisgarh, India 5 Department of Critical Care, Bansal Hospital, Bhopal, Madhya Pradesh, India 6 Jabalpur Hospital & Research Centre, Jabalpur, Madhya Pradesh, India 2 Department of Quality Assurance, National Health Mission, Government of Madhya Pradesh, Bhopal, Madhya Pradesh, India 7 Department of Pulmonology, Anant Hospital, Jabalpur, Madhya Pradesh, India 8 Department of Medical Services, Choithram Hospital, Indore, Madhya Pradesh, India 9 Department of Surgery, Medanta Hospital, Indore, Madhya Pradesh, India 13 Department of Microbiology, Govt. P.C. Sethi Hospital, Indore, Madhya Pradesh, India 10 Department of Critical Care, Rajshree Apollo Hospital, Indore, Madhya Pradesh, India 14 AMR Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India 4 Department of General Medici |
| AuthorAffiliation_xml | – name: 1 Department of General Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India – name: 10 Department of Critical Care, Rajshree Apollo Hospital, Indore, Madhya Pradesh, India – name: 11 Department of Critical Care, Metro Hospital & Cancer Research Centre, Jabalpur, Madhya Pradesh, India – name: 9 Department of Surgery, Medanta Hospital, Indore, Madhya Pradesh, India – name: 4 Department of General Medicine Govt. J.P. Hospital, Bhopal, Madhya Pradesh, India – name: 6 Jabalpur Hospital & Research Centre, Jabalpur, Madhya Pradesh, India – name: 3 Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India – name: 8 Department of Medical Services, Choithram Hospital, Indore, Madhya Pradesh, India – name: 2 Department of Quality Assurance, National Health Mission, Government of Madhya Pradesh, Bhopal, Madhya Pradesh, India – name: 7 Department of Pulmonology, Anant Hospital, Jabalpur, Madhya Pradesh, India – name: 14 AMR Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India – name: 12 Department of Medical Oncology, Balco Medical Centre, Raipur, Chhattisgarh, India – name: 13 Department of Microbiology, Govt. P.C. Sethi Hospital, Indore, Madhya Pradesh, India – name: 5 Department of Critical Care, Bansal Hospital, Bhopal, Madhya Pradesh, India |
| Author_xml | – sequence: 1 givenname: Shweta surname: Kumar fullname: Kumar, Shweta organization: Department of General Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India – sequence: 2 givenname: Pankaj surname: Shukla fullname: Shukla, Pankaj organization: Department of Quality Assurance, National Health Mission, Government of Madhya Pradesh, Bhopal, Madhya Pradesh, India – sequence: 3 givenname: Pramod orcidid: 0000-0002-0806-6085 surname: Goel fullname: Goel, Pramod organization: Department of Quality Assurance, National Health Mission, Government of Madhya Pradesh, Bhopal, Madhya Pradesh, India – sequence: 4 givenname: Vivek surname: Mishra fullname: Mishra, Vivek organization: Department of Quality Assurance, National Health Mission, Government of Madhya Pradesh, Bhopal, Madhya Pradesh, India – sequence: 5 givenname: Ayush surname: Gupta fullname: Gupta, Ayush organization: Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India – sequence: 6 givenname: Tadepalli surname: Karuna fullname: Karuna, Tadepalli organization: Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India – sequence: 7 givenname: Rakesh surname: Srivastava fullname: Srivastava, Rakesh organization: Department of General Medicine Govt. J.P. Hospital, Bhopal, Madhya Pradesh, India – sequence: 8 givenname: Amit orcidid: 0000-0001-9247-9204 surname: Gupta fullname: Gupta, Amit organization: Department of Critical Care, Bansal Hospital, Bhopal, Madhya Pradesh, India – sequence: 9 givenname: Deepak surname: Baharani fullname: Baharani, Deepak organization: Jabalpur Hospital & Research Centre, Jabalpur, Madhya Pradesh, India – sequence: 10 givenname: Parijat surname: Pansey fullname: Pansey, Parijat organization: Department of Pulmonology, Anant Hospital, Jabalpur, Madhya Pradesh, India – sequence: 11 givenname: Sunil surname: Chandiwal fullname: Chandiwal, Sunil organization: Department of Medical Services, Choithram Hospital, Indore, Madhya Pradesh, India – sequence: 12 givenname: Sandeep surname: Shrivastava fullname: Shrivastava, Sandeep organization: Department of Surgery, Medanta Hospital, Indore, Madhya Pradesh, India – sequence: 13 givenname: Ankur surname: Gupta fullname: Gupta, Ankur organization: Department of Critical Care, Rajshree Apollo Hospital, Indore, Madhya Pradesh, India – sequence: 14 givenname: Shailendra Singh surname: Rajpoot fullname: Rajpoot, Shailendra Singh organization: Department of Critical Care, Metro Hospital & Cancer Research Centre, Jabalpur, Madhya Pradesh, India – sequence: 15 givenname: DebaDulal surname: Biswal fullname: Biswal, DebaDulal organization: Department of Medical Oncology, Balco Medical Centre, Raipur, Chhattisgarh, India – sequence: 16 givenname: Mehrunnisa surname: Ansari fullname: Ansari, Mehrunnisa organization: Department of Microbiology, Govt. P.C. Sethi Hospital, Indore, Madhya Pradesh, India – sequence: 17 givenname: Kamini surname: Walia fullname: Walia, Kamini organization: AMR Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India – sequence: 18 givenname: Sagar surname: Khadanga fullname: Khadanga, Sagar organization: Department of General Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India |
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| Cites_doi | 10.4103/jfmpc.jfmpc_1473_20 10.2807/1560-7917.ES.2019.24.33.1900015 10.1186/s13052-019-0645-7 10.1016/S2214-109X(19)30071-3 10.4103/0971-5916.164228 10.1016/j.ajic.2015.10.008 10.1016/j.mib.2019.10.008 10.2147/IDR.S299774 10.3390/antibiotics3030450 10.1080/14787210.2019.1581063 10.7196/SAMJ.9644 10.1016/j.jiph.2014.07.001 10.1016/j.ijantimicag.2006.10.020 10.1016/S2542-5196(21)00280-1 10.3390/ijerph17207536 |
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| Keywords | antibiotic usage antimicrobial stewardship program point prevalence study antibiotic consumption antimicrobial resistance |
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| Snippet | Indian hospitals (especially government-run public sector hospitals) have a nonexistent antimicrobial stewardship program (AMSP). After successfully initiating... Abstract Objective Indian hospitals (especially government-run public sector hospitals) have a nonexistent antimicrobial stewardship program (AMSP). After... Objective Indian hospitals (especially government-run public sector hospitals) have a nonexistent antimicrobial stewardship program (AMSP). After successfully... Objective Indian hospitals (especially government-run public sector hospitals) have a nonexistent antimicrobial stewardship program (AMSP). After successfully... |
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| StartPage | 259 |
| SubjectTerms | antibiotic consumption antibiotic usage antimicrobial resistance antimicrobial stewardship program Original point prevalence study |
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| Title | Point Prevalence Study (PPS) of Antibiotic Usage and Bacterial Culture Rate (BCR) among Secondary Care Hospitals of Small Cities in Central India: Consolidating Indian Evidence |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/37323604 https://search.proquest.com/docview/2827254609 https://pubmed.ncbi.nlm.nih.gov/PMC10264115 https://doaj.org/article/2d8e83ff04a94d6a932b07ab9ca83970 |
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