Abstract

A STUDY ON ANTIMICROBIAL STEWARDSHIP AMONG IN-PATIENTS OF A TERTIARY CARE HOSPITAL

Ryngkatbor Marbaniang*, Albert Matthew, Dr. E Satheesh Kumar, Mohammed Afreedi, Manju Baruah and Dr. L Padma

ABSTRACT

Improper utilization like overuse, non-prescription usage and misuse of antimicrobial contribute to the serious consequences of antimicrobial resistance. This phenomena of resistance is increasing rapidly day by day all over the world, which may donate complications like serious infections, higher mortality rate, and increases hospital length of stay. If Antimicrobial are appropriately use in accordance with the guidelines and consume only whenever necessary, antimicrobial resistance may decline and that will ensure a safe, equitable and efficient disease management. Antimicrobial stewardship is a strategy that promote the responsible utilization of antimicrobial by providing coherent set of rules. This programme can ensure the appropriate use of drugs through the application of evidence based interventions. Antimicrobial stewardship provides an outlook to upgrade clinical outcomes and in abating unfavourable effects caused by the drug. The rational use of antimicrobial was analyse by using treatment guidelines for antimicrobial use in common syndrome by Indian council of Medical Research and National Formulary of India guidelines. The study will also determine the potential drug-drug interactions, drugs exhibiting additive effects and contraindicating drugs using Micromedex. The study was conducted for a period of 6 months, a total of 270 inpatient cases of General Medicine department were collected and analyzed. The overall appropriateness of rational use of antimicrobials was observed to be 91.4%. The appropriateness with reference to indication was found to be 92.87%, for Dose it was 92.45%.With respect to frequency and duration it was 90.56% and 89.72% respectively. Drug interactions were found in 59 cases of which 42 were major (71.18%), 13 were moderate (23.03%) and 4 were minor (6.78%) in severity. A total of 35 drug combinations were observed from the prescription having capability to exhibit an additive action, out of which 3 drug combinations on analyzing treatment charts were found to be contraindicating.

Keywords: Antimicrobial, Rationality, Utilization, Adherence, Antimicrobial-resistance.