Diagnose-Specific Antibiotic Prescribing Patterns at Otorhinolaryngology Inpatient Departments of Two Private Sector Healthcare Facilities in Central India: A Five-Year Observational Study

Elisabeth Silfwerbrand, Sumeer Verma, Cora Sjökvist, Cecilia Stålsby Lundborg and Megha Sharma
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Elisabeth Silfwerbrand: Department of Public Health Sciences, Global Health-Health Systems and Policy (HSP): Medicines, focusing antibiotics, Karolinska Institutet, 171 77 Stockholm, Sweden
Sumeer Verma: Department of Otorhinolaryngology, Ruxmaniben Deepchand Gardi Medical College, Ujjain 456006, India
Cora Sjökvist: Department of Public Health Sciences, Global Health-Health Systems and Policy (HSP): Medicines, focusing antibiotics, Karolinska Institutet, 171 77 Stockholm, Sweden
Cecilia Stålsby Lundborg: Department of Public Health Sciences, Global Health-Health Systems and Policy (HSP): Medicines, focusing antibiotics, Karolinska Institutet, 171 77 Stockholm, Sweden
Megha Sharma: Department of Public Health Sciences, Global Health-Health Systems and Policy (HSP): Medicines, focusing antibiotics, Karolinska Institutet, 171 77 Stockholm, Sweden

IJERPH, 2019, vol. 16, issue 21, 1-15

Abstract: Antibiotics are over-prescribed in low-and-middle-income countries, where the infection rate is high. The global paucity of standard treatment guidelines and reliable diagnose-specific prescription data from high-infection risk departments such as the otorhinolaryngology (ENT: ears, nose and throat) is a barrier to rationalize antibiotic use and combat antibiotic resistance. The study was conducted to present diagnose-specific antibiotic prescribing patterns of five years at ENT inpatient departments of two private-sector Indian hospitals. Data of all consecutive inpatients ( n = 3527) were collected but analyzed for the inpatients aged >15 years ( n = 2909) using the World Health Organization’s methodologies. Patient records were divided into four diagnoses groups: surgical, non-surgical, chronic suppurative otitis media (CSOM), and others. Of 2909 inpatients, 51% had surgical diagnoses. An average of 83% of patients in the clean surgery group and more than 75% in the viral and non-infectious groups were prescribed antibiotics. CSOM was the most common diagnosis (31%), where 90% of inpatients were prescribed antibiotics. Overall, third-generation cephalosporins and fluoroquinolones were most commonly prescribed. This study highlights the inappropriate prescribing of antibiotics to patients of clean surgeries, viral infections, and non-infectious groups. The single-prophylactic dose of antibiotic for clean-contaminated surgeries was replaced by the prolonged empirical prescribing. The use of microbiology investigations was insignificant.

Keywords: Otorhinolaryngology; single-dose surgical prophylaxis; chronic suppurative otitis media; diagnose-specific antibiotic prescribing patterns; private healthcare sector; India (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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