Do Private Practitioners in Puducherry, South India, Adhere to World Health Organization Drug Prescribing Standards? Need for Antimicrobial Stewardship in Private Sector.

Background: Private practitioners play a key role in addressing the healthcare needs of a large proportion of the Indian population. While several studies have explored drug prescribing practices in India, a gap exists in understanding the drug prescribing patterns of private practitioners.

Objectives: This study described the drug prescribing patterns of private practitioners using World Health Organization (WHO) prescribing indicators, with a focus on estimating the proportion of antibiotics prescribed based on AWaRe (ACCESS, WATCH, and RESERVE) classification.

Materials and methods: The study used a cross-sectional descriptive design. The prescriptions of private practitioners were collected from customers at 20 pharmacies in Puducherry, South India from September to November 2023.

Results: A total of 600 prescriptions were included in the analysis. About one-third (33.7%) of prescriptions collected were for individuals aged 31-45 years, whereas least (6.3%) were for those <18 years. The antibiotic prescription rate was 38.8%, exceeding WHO standards (20%-26.8%), with 61.4% falling in the WATCH category, below the WHO target of ≥60% ACCESS category. Polypharmacy was observed, averaging 3.6 drugs per prescription, exceeding the WHO standards (1.6-1.8 drugs). Generic name prescription was only 0.2%, deviating from the WHO's 100% standard. Injections were prescribed in only 3.5% of prescriptions, below the WHO standards (13.4%-24.1%). Furthermore, only 52.8% of prescribed drugs were on the National Essential Medicine List (NEML) of India, 2022, below the WHO's 100% NEML prescription standards.

Conclusion: This study has highlighted the practice of polypharmacy, higher preference for branded drugs and antibiotics, and a lesser utilization of NEML-listed medications by the private practitioners in Puducherry.