Standardizing Antimicrobial Prescribing Patterns and Emphasizing Microbiologist’s Accountability: A Prospective Study

Abstract

Introduction:

Antimicrobial drugs are crucial to the therapeutic treatment of illnesses and are offered in both inpatient and outpatient settings. Most bacterial infections are treated with antimicrobials. Clinical treatment, the economy, and the environment are all impacted by their use. Using the wrong drug for an infection, delivering the wrong dosage, giving the right medication in the wrong way, and not completing the complete recommended course of treatment are all examples of antimicrobial misuse. The overuse and abuse of antibiotics leads to the development of antimicrobial resistance. Drug resistance has been observed in microbes of various kinds.

Hospital stays, mortality, morbidity, and medical costs are all increased by antibiotic resistance. Medical costs are higher for people with infections brought on by antimicrobial-resistant organisms than for those with illnesses brought on by organisms susceptible to antibiotics. Standardized prescribing procedures will result in more cost-effective health care. The study is to collect relevant clinical history, antibiotic prescribing patterns, and antibiotic sensitivity in addition to emphasizing the importance of a multidisciplinary approach in antimicrobial prescription.

Objectives:

• To identify the clinical diagnosis and the antibiotics prescribed (either empirical or based on culture and sensitivity) for the patients enrolled in this study.
• To identify the documented infective organism isolated and to identify the sensitivity / resistance patterns observed in these patients.

Methodology:

Every sample was processed by our microbiology department using pertinent clinical data gathered from the surgical and medical intensive care units. Both morphological and biochemical analyses were performed. On the same day, antibiotic sensitivity testing was performed in Mueller Hinton agar using 0.5 McFarland standards. Based on the size of the zone, the CLSI guidelines categorized the antimicrobials as susceptible, intermediate, resistant, dosage dependant, and sensitive. If any fungus was grown in Sabouraud's dextrose agar, then further processing was done based on the microscope's findings. All of the patient's information was collected from the doctors and case files, including the diagnosis, antibiotics given, dosage, duration of treatment, and length of stay. Costs, consumption rates, and the appropriateness of antibiotic use were all computed. Mortality rate was also calculated.

Conclusion:

The most frequently isolated organism in our investigation was Klebsiella pneumoniae, while the least frequently cultivated species were Streptococcus pneumonia and Enterococcus faecalis. Common specimens that commonly displayed microbial growth were urine, sputum, and pus. In half of the patients who tested positive for Staphylococcus aureus at first, an MRSA infection was later isolated from their urine and pus samples.

The most common clinical diseases for which antibiotics were recommended were lower respiratory tract infections, urinary tract infection-associated sepsis, and chronic obstructive pulmonary disease (COPD). There are a number of possible consequences when people are aware of the negative effects of antibiotic resistance, such as higher mortality, longer hospital stays, and higher expenses. Healthcare professionals can assist avoid such illnesses by using measures including infection-control strategies and antimicrobial agent management plans.