Abstract
Point prevalence surveys (PPS) have been used to document antimicrobial use in healthcare
organizations. Antimicrobial resistance is a global concern, more so for developing
countries like India, where the burden of antimicrobial resistance and infectious
diseases are very high. A web based PPS developed by University of Antwerp, Belgium
for the Antibiotic Resistance and Prescribing in European Children (ARPEC) project
was used to enter data from pediatric and neonatal wards and intensive care units
(ICU) from 8 centers across India. All patients who were receiving systemic antibacterial
treatments on the day of the survey inclusive of antibacterial prophylaxis for surgery
were included. 195 patients were surveyed across India: 105 (54%) medical and 90 (46%)
surgical. 192 (98%) patients received multiple antimicrobials out of which 187 (95%)
were given parenterally. Empirical antimicrobials were prescribed in 138 (71%) patients
and targeted therapy in 57 (29%). The commonest infections for which antimicrobials
were prescribed were healthcare associated infections 180 (41.76%) followed by surgical
prophylaxis 90 (21%) and community acquired infections 84 (18%). Antimicrobials usage
was maximal in ICUs. More than a single dose (5.6%) for more than a day (86.7%) was
used for surgical prophylaxis. The Web based PPS suggests widespread antibiotic usage
among pediatric and neonatal patients in selected tertiary Indian hospitals and underscores
the need for antibiotic stewardship in order to promote rational and evidence based
practice to limit the emergence of antibiotic resistant microbes.
Keywords
Point prevalence surveys - antimicrobial resistance - prophylaxis
