Contextualizing the Relevance of Antimicrobial Resistance in the Drug Prescription and Consumption Pattern of a Tertiary Level Hospital

Published: October 8, 2018

Authors

B. Bhardwaj, A. Mahajan, M. Singh, R. Roy, R. Sharma

Keywords
Antimicrobial Resistance, Antimicrobial Stewardship, Antimicrobial Consumption, Defined Daily Dose, Intensive Care Units

Abstract

Rampant, irrational and unscientific use of antimicrobials by the healthcare practitioners is adding to the problem of antimicrobial resistance. Therefore, it is of utmost importance to evolve and implement new policies, recommence research actions and pursue steps to manage the crisis of antimicrobial resistance, which can be accomplished by a well-designed Antimicrobial Stewardship programme. A prospective observational study aiming to investigate the use of antimicrobials in Intensive Care Units by means of an AMS programme was carried out in a 400 bedded tertiary level hospital in New Delhi with 140 ICU beds. This evidence-based study looks
into the prescription and consumption of antimicrobials, specifically in the ICUs, and attempts to corelate it with the resistance pattern of antimicrobials being used. All the patients being treated with antimicrobials, admitted in the ICUs of the hospital were selected for this descriptive research. Information associated with antimicrobials including the susceptibility pattern of isolates and full dosage regime of each patient from the group was obtained by conducting daily audits for a period of five months. Among the usage of different antimicrobial categories (antibacterial, antifungal and antiviral), the resistance percentage correlation was predominantly focused on the
antibacterial. However, the study suggests no conclusive direct or indirect correlation between the usage of an antibacterial (in terms of prescription and consumption) and its resistance, which itself could be a cause of concern for medical practitioners.

References

Alyssa, R. (2018). Cephalosporins. UpToDate Website: https://www.uptodate.com/contents/cephalosporins

Antibiotic / Antimicrobial Resistance (AR / AMR), Centers for Disease Control and Prevention Website: https://www.cdc.gov/drugresistance/about.html

Antimicrobial Resistance, World Health Organization Website: https://www.who.int/antimicrobial-resistance/en/

Antimicrobial Stewardship: A competency-based approach, World Health Organization Website: https://openwho.org/courses/AMR-competency

ATC/DDD Index 2019, WHO Collaborating Centre for Drug Statistics Methodology Website: http://www.whocc.no/atcddd/

Austin, D. J., Kristinsson, K. G., & Anderson, R. M. (1999). The relationship between the volume of antimicrobial consumption in human communities and the frequency of resistance. Proceedings of the National Academy of Sciences, 96(3), 1152–1156. https://doi.org/10.1073/pnas.96.3.1152

Bae, S., Kim, M. C., Park, S. J., Kim, H. S., Sung, H., Kim, M. N., … & Kim, Y. S. (2016). In vitro synergistic activity of antimicrobial agents in combination against clinical isolates of colistin-resistant Acinetobacterbaumannii. Antimicrobial agents and chemotherapy, AAC-00839. https://dx.doi.org/10.1128%2FAAC.00839-16

DDD Indicators, World Health Organization Website: https://www.who.int/medicines/regulation/medicines-safety/toolkit_indicators/en/

Definition and General Considerations, WHO Collaborating Centre for Drug Statistics Methodology Website: www.whocc.no/ddd/definition_and_general_considera/

Griffith, M., Postelnick, M., & Scheetz, M. (2012). Antimicrobial stewardship programs: methods of operation and suggested outcomes. Expert review of

anti-infective therapy, 10(1), 63–73. https://doi.org/10.1586/eri.11.153

Jamshidi, M., Javadpour, S., Eftekhari, T. E., Moradi, N., & Jomehpour, F. (2009). Antimicrobial resistance pattern among intensive care unit patients. African Journal of Microbiology Research, 3(10), 590–594.

Laxminarayan, R., Duse, A., Wattal, C., Zaidi, A. K., Wertheim, H. F., Sumpradit, N., … &Greko, C. (2013). Antibiotic resistance—the need for global solutions. The Lancet infectious diseases, 13(12), 1057–1098.https://doi.org/10.1016/S1473-3099(13)70318-9

Lim, C., Takahashi, E., Hongsuwan, M., Wuthiekanun, V., Thamlikitkul, V., Hinjoy, S., … &Limmathurotsakul,D. (2016). Epidemiology and burden of multidrug-resistant

bacterial infection in a developing country. Elife, 5, e18082. PDF: https://cdn.elifesciences.org/articles/18082/elife-18082-v1.pdf

Marschner, J. P., Thürmann, P., Harder, S., &Rietbrock, N. (1994). Drug utilization review on a surgical intensive care unit. International journal of clinical pharmacology

and therapeutics, 32(9), 447–451. PMID: 7820326

Merzougui, L., Barhoumi, T., Guizani, T., Barhoumi, H., Hannachi, H., Turki, E., &Majdoub, W. (2018). Les infections nosocomialesen milieu de réanimation:

incidence annuelle et aspects cliniques au Service de RéanimationPolyvalente, Kairouan, Tunisie, 2014. The Pan African medical journal, 30. https://dx.doi.org/10.11604%2Fpamj.2018.30.143.13824

Metrics and Evaluation. Public Health Ontario: https://www.publichealthontario.ca/fr/eRepository/ASP%20Metric%20examples.pdf

Penicillins, O. (2000). Appropriate prescribing of oral betalactam antibiotics. Am Fam Physician, 62, 611–620. http://www.p-e-g.de/Research_News/10092000-6.html

Sharma, P. R., & Barman, P. (2010). Antimicrobial consumption and impact of “Reserve antibiotic indent form” in an intensive care unit. Indian journal of pharmacology, 42(5), 297. https://doi.org/10.4103/0253-7613.70216

Spellberg, B., & Gilbert, D. N. (2014). The future of antibiotics and resistance: a tribute to a career of leadership by John Bartlett. Clinical infectious diseases, 59(suppl_2),

S71–S75. https://doi.org/10.1093/cid/ciu392

Sulieman, H., El-Mahdi, W., Awadelkareem, M., &Nazer, L. (2018). Characteristics of Critically-Ill Patients at Two Tertiary Care Hospitals in Sudan. Sultan Qaboos University Medical Journal, 18(2), e190. https://dx.doi.org/10.18295%2Fsqumj.2018.18.02.011

Surveillance of Antimicrobial Use, World Health Organization Website: https://www.who.int/medicines/areas/rational_use/AMU_Surveillance/en/

Toptas, M., SengulSamanci, N., Akkoc, İ., Yucetas, E., Cebeci, E., Sen, O., … & Ozturk, S. (2018). Factors Affecting the Length of Stay in the Intensive Care

Unit: Our Clinical Experience. BioMed research international, 2018. https://dx.doi.org/10.1155%2F2018%2F9438046

How to Cite

B. Bhardwaj, A. Mahajan, M. Singh, R. Roy, R. Sharma. Contextualizing the Relevance of Antimicrobial Resistance in the Drug Prescription and Consumption Pattern of a Tertiary Level Hospital. J. Multidiscip. Res. Healthcare. 2018, 05, 25-32
Contextualizing the Relevance of Antimicrobial Resistance in the Drug Prescription and Consumption Pattern of a Tertiary Level Hospital

Current Issue

PeriodicityBiannually
Issue-1October
Issue-2April
ISSN Print2393-8536
ISSN Online2393-8544
RNI No.CHAENG/2014/57978
OA Policy

Publisher's policy of the journal at Sherpa UK for the submitted, accepted, and published articles. Click OAPolicy

Plan-S Compliance

To check compliance, one has to use the Journal Check Tool (JCT). This tool provided by cOAlition S (European funders) for the researchers (fundee) to check the compliance with the journal.

Recommend journal to your library

You can recommend the journal being a researcher or faculty member to your library. We will post a copy of the Journal to your library on your behalf at free of cost.
Click here: Recommend Journal

Preprint Arxiv Submission

The authors are encouraged to submit the author’s copy (preprint) to appropriate preprint archives e.g. https://arxiv.org and/or on https://indiarxiv.org or institutional repositories (e.g., D Space) before paper acceptance by the editor of Journal. After publications of the paper author(s) should mention the citation information, title and abstract along with DOI number of the publication carefully on the required page of the depository(ies).

Contact:

Phone: +91-172-2741000, +91-172-4691800
Email : editor.jmrh@chitkara.edu.in

Abstract and Indexing

This work is licensed under a Creative Commons Attribution 4.0 International License.

Articles in Journal of Multidisciplinary Research in Healthcare by Chitkara University Publications are Open Access articles that are published with licensed under a Creative Commons Attribution- CC-BY 4.0 International License. Based on a work at https://jmrh.chitkara.edu.in/. This license permits one to use, remix, tweak and reproduction in any medium, even commercially provided one give credit for the original creation.

View Legal Code of the above-mentioned license, https://creativecommons.org/licenses/by/4.0/legalcode

View Licence Deed here https://creativecommons.org/licenses/by/4.0/

Creative Commons License

Journal of Multidisciplinary Research in Healthcare by Chitkara University Publications is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at https://jmrh.chitkara.edu.in/

Members