Assessment of Irrational Use of Antibiotics at a Tertiary Care Hospital in Kharian, Pakistan
Keywords:
Antimicrobial stewardship, Antimicrobial resistance, Drug Utilization, Prescription patterns, Antibacterial agentsAbstract
Background: Inappropriate antibiotic prescribing contributes substantially to antimicrobial resistance, prolonged hospitalization, and increased healthcare costs. Evidence regarding the magnitude of irrational antibiotic use in tertiary care hospitals in Pakistan remains limited. This study aimed to assess the pattern of antibiotic prescribing and determine the frequency of irrational antibiotic use among hospitalized patients at a tertiary care hospital in Kharian, Pakistan.
Methodology: A cross-sectional descriptive study was conducted among 385 hospitalized patients aged ≥18 years who had been admitted for more than 24 hours and were receiving at least one antibiotic. Data regarding demographic characteristics, temperature, indication for antibiotic therapy, antibiotic class, laboratory investigations (complete blood count, urine routine examination, and culture and sensitivity reports where available), were collected using a structured data collection form. Descriptive statistics were performed using SPSS version 20. Irrational antibiotic use was assessed based on the absence of clinical or laboratory evidence of bacterial infection and the lack of culture-guided therapy.
Results: A total of 385 patients (mean age: 42.5 ± 18.1 years) were included, with a mean hospital stay of 4.2 ± 4.3 days. Overall, 555 antibiotics were prescribed; 224 (58.2%) patients received one antibiotic, 152 (39.5%) received two antibiotics, and 9 (2.3%) received more than two antibiotics. Empirical antibiotic therapy without prior culture and sensitivity testing was observed in 333 (86.5%) patients. Penicillins were the most frequently prescribed antibiotics (14.5%), followed by the combination of cephalosporins and metronidazole (13.8%). Genitourinary infections were the most common documented indication (17.9%). However, 202 (52.4%) patients received antibiotics despite the absence of laboratory evidence suggestive of bacterial infection.
Conclusion: A high proportion of hospitalized patients received empirical antibiotics, and more than half were prescribed antibiotics without objective laboratory evidence of bacterial infection. These findings highlight the need to strengthen antimicrobial stewardship strategies and promote evidence-based antibiotic prescribing practices in tertiary care hospitals.
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