Antimicrobial Resistance Patterns and the Role of Antibiotic Stewardship in a Secondary Care Hospital.

Abstract

Background: Antimicrobial Resistance (AMR) has emerged as a critical global health challenge, with bacteria, viruses, fungi, and parasites developing the capacity to survive antimicrobial treatments. This resistance, largely driven by increased antibiotic usage, threatens public health by diminishing the effectiveness of current infection management strategies.

Aim and objectives: This study aims to evaluate the antimicrobial resistance patterns of prevalent pathogens in a secondary care hospital, highlighting the essential role of clinical pharmacists in addressing AMR through the implementation of Antibiotic Stewardship Programs (ASPs) to promote responsible antibiotic use.

Methodology: This prospective study analyzed 80 positive microbial culture reports from six months. Ethical approval was granted by the Institutional Ethical Committee (Ref: ECR/288/Indt/TN/2018/RR-21/001, dated April 6, 2023). Inclusion criteria covered adults (≥18 years) with confirmed infections across various sites, including bloodstream, urinary, respiratory, and soft tissue. Exclusion criteria eliminated reports with no pathogen growth. Data were analyzed using SPSS software version 26.0, with statistical measures applied to assess resistance patterns and correlations across infection types.

Results: Of the 80 positive cultures, Escherichia coli 35.0%) was most frequently isolated, followed by Klebsiella pneumoniae (12.5%), Pseudomonas aeruginosa (8.8%), Proteus mirabilis (8.8%), and Klebsiella oxytoca (7.5%). The isolated pathogens displayed high resistance to ampicillin (82.5%), cefixime (80.0%), ceftriaxone (78.8%), and ceftazidime (71.3%), with a strong sensitivity to amikacin (86.3%) and meropenem (70.0%).

Conclusion: The rise of third-generation cephalosporin-resistant pathogens signals an urgent need for sustained AMR monitoring and robust ASPs in healthcare settings, particularly in developing regions. The study underscores the importance of rational antibiotic use and continuous AMR surveillance to curb resistant infections and protect public health.