Patterns of Antimicrobial Consumption in a Tertiary Care Teaching Hospital in Zahedan, Southeast of Iran

Abstract

Background: The inappropriate consumption of antibiotics in hospital wards increases antimicrobial resistance, morbidity, mortality, and associated treatment costs. Objectives: This cross-sectional study was carried out to measure antibiotic utilization in a tertiary care hospital in Zahedan, southeast of Iran. Methods: In this study, antibiotic utilization was measured using the defined daily dose (DDD)/100 bed-days (DBD) index based on the anatomical therapeutic chemical/defined daily dose classification system that is proposed by the World Health Organization. By the adoption of the stratified random sampling method, the hospital records of a total of 525 patients admitted to seven hospital wards were extracted from the hospital health information system. Results: The consumption of antibiotics was 85.9 DBD. More than 73% of the patients were prescribed antimicrobials during admission. The highest proportion of antibacterial therapy was observed in the obstetrics and gynecology ward, followed by surgical and internal medicine wards. Cephalosporins and cotrimoxazole were the most commonly prescribed antibiotic class and individual antibiotic, with 37.1 and 13.4 DBD, respectively. Generally, 261 of 384 patients who were given antibiotics (68%) received parenteral antibiotic therapy. A total of 173 out of 225 patients admitted to surgical wards underwent surgery, 75% of whom received antibiotics as prophylaxis. Conclusions: Although the pattern of antibacterial consumption was lower than other hospitals in Iran, the total amount of DBD was more than the data published for some developing and developed countries. Specific strategies should be employed to develop guidelines for rational antibiotic utilization for reducing future resistant strains and increasing antimicrobial efficacy.