Research

Prescribing patterns of antibiotics and sensitivity patterns of common microorganisms in the Internal Medicine ward of a teaching hospital in Western Nepal: a prospective study

Ravi Pathiyil Shankar¹ , Praveen Partha² , Nagesh Kumar Shenoy³ , Joshy Maducolil Easow⁴ and Kottallur Narayanan Brahmadathan⁴

¹  Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Nepal

²  Department of Internal Medicine, Manipal Teaching Hospital, Pokhara, Nepal

³  Department of Pharmacy, Manipal Teaching Hospital, Pokhara, Nepal

⁴  Department of Microbiology, Manipal Teaching Hospital, Pokhara, Nepal

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Annals of Clinical Microbiology and Antimicrobials 2003, 2:7doi:10.1186/1476-0711-2-7

Published:	16 July 2003

Abstract

Background

Information about antibiotic use and resistance patterns of common microorganisms are lacking in hospitals in Western Nepal. Excessive and inappropriate use of antibiotics contributes to the development of bacterial resistance. The parameter: Defined daily dose/100 bed-days, provides an estimate of consumption of drugs among hospital in-patients. This study was carried out to collect relevant demographic information, antibiotic prescribing patterns and the common organisms isolated including their antibiotic sensitivity patterns.

Methods

The study was carried out over a 3-month period (01.04.2002 to 30.06.2002) at the Manipal Teaching Hospital, Western Nepal. The median number of days of hospitalization and mean ± SD cost of antibiotics prescribed during hospital stay were calculated. The use of antibiotics was classified for prophylaxis, bacteriologically proven infection or non-bacteriologically proven infection. Sensitivity patterns of the common organisms were determined. Defined daily dose/100 bed-days of the ten most commonly prescribed antibiotics were calculated.

Results

203 patients were prescribed antibiotics; 112 were male. Median duration of hospitalization was 5 days. 347 antibiotics were prescribed. The most common were ampicillin, amoxicillin, metronidazole, ciprofloxacin and benzylpenicillin. Mean ± SD cost of antibiotics was 16.5 ± 13.4 US$. Culture and sensitivity testing was carried out in 141 patients. The common organisms isolated were H. influenzae, E. coli, K. pneumoniae and S. aureus.

Conclusions

Antibiotic resistance is becoming a problem in the Internal Medicine ward. Formulation of a policy for hospital antibiotic use and an educational programme especially for junior doctors is required.