RESUMO
Background: Antimicrobials play cardinal role in management of infectious disease. Paediatric age group forms significant part of developing countries and have high chances of acquiring infectious. Misuse and overuse of these antimicrobials are leading culprits in causing antimicrobials resistance. The purpose of this study was to analyse utilization of antimicrobials among paediatric department of a tertiary care teaching hospital. Methods: A cross sectional observation study was conducted for three months in paediatric department of a tertiary care teaching hospital. The demographics and antimicrobials use details were observed daily from patients admitted to paediatric outpatient department, wards and intensive care unit to assess according to The World Health Organization-International Network of Rational Use of Drugs drug prescribing indicators and WHO antibiotics AWaRe (Access, Watch, Reserve) classification. Results: In our study we found that mean antimicrobial use in OPD, wards and ICU was1.15±0.35, 1.12±0.33 and 2.25±1.01 respectively. Cephalosporins were most commonly prescribed in OPD (34.62%) and wards (65.26%) while piperacillin-tazobactam (29.93%) in ICU. Percent encounter with an antibiotic in OPD, Wards and ICU was 8.41%, 30.71% and 33.58% respectively. 56.69%, 81.35% and 55.80% antibiotics prescribed in OPD, Wards and ICU respectively were of Watch group. 5.66% Reserve group antibiotics were prescribed in the ICU. Conclusions: Prescribing trends of antimicrobials is near to WHO standard but according to AWaRe classification, watch group antibiotics were prescribed more than Access group.
RESUMO
Background: This study measured the impact of the first and second wave of COVID-19 pandemic (in the year 2020-21) on the antibiotics uses and their effect on gram nehative bacterial species Klebsiella, Enterobacter, Pseudomonas and Acinetobacter. Methods: The number of patient admission month-wise, antibiotic consumption, blood cultures collected, number of positive BCs, and antibiotic resistance were analysed retrospectively for the years 2020, 2021, and 2019 for comparison, in tertiary care hospital (ca. 840 beds). Results: Half of patients admitted in years 2020 and 2021 in our hospital had COVID-19. A significant increase in total antibiotic consumption during the years 2020 (75.53 DDD per 100 admissions) and 2021 (91.71 DDD per 100 admissions) occurred in comparison to the year 2019 (52.5 DDD per 100 admissions). The rate ratio of BCs per 100 admissions increased by 74% in the year 2020, and 118% in the year 2021 in comparison with the rate ratio to the year 2019. The BSI rate per 100 admissions increased overall by 24% in March 2020 and 115% in April 2020, the rate ratio of BSIs per 100 admissions raised 58.4% for Klebsiella and 239.3% for E. coli, but remain the same for Acinetobacter and Aeruginosa. A sharp increase in the rate of BSIs caused by microorganisms resistant to cephalosporins was also observed in the years 2020 and 2021. Conclusions: present study highlights the impact of the first and second waves of the COVID-19 pandemic on antibiotic consumption and the increasing prevalence hospital-acquired infections and antimicrobial resistance.