Assessment of Antibiotics Prescribing Using WHO/ INRUD Indicators and AWaRe Classification in an Indian Regional Hospital

Antimicrobial resistance and irrational antibiotic use are global concerns. Assessing prescribing practices based on drug use indicators and AWaRe classification can help to enhance the healthcare system's standards. A six-month prospective observational study was conducted at a regional tertiary hospital in India, involving patients from various departments who were hospitalized. Data from patient case sheets were analyzed using WHO/International Network of Rational Use of Drugs (INRUD) core prescribing indicators and AWaRe classification, with Microsoft Excel and SPSS 2 for data analysis. In a study of 306 patients, 670 antibiotics were prescribed, revealing significant deviations from World Health Organization (WHO) standards. Access group antibiotics usage was 30% (target: 60%), while the watch group usage was high at 69.25%. Broad-spectrum antibiotics were prescribed in 85.53% of cases, and beta-lactamase inhibitor combinations in 40%, contributing to antimicrobial resistance. Only 49.85% of antibiotics were from the National Essential Drugs List (target 100%). The hospital lacks its own institutional Standard Therapeutic Guidelines (STG), a formulary List (FL), and a diagnostic tool, ‘the culture and the sensitivity test’, to choose antibiotics for specific infections was poorly performed. As a global community, it is essential now to stop discussing and move beyond the antimicrobial resistance problem by implementing solutions. Establishing antimicrobial stewardship programs (ASP) from the regional healthcare settings in India helps promote prudent antibiotic use.  Strengthening the healthcare system could make this achievable.

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