TRENDS OF ANTIBIOTIC UTILIZATION OVER A PERIOD OF 13 YEARS AT A TERTIARY CARE CENTER IN KARACHI, PAKISTAN

Abstract

Intro: Antimicrobial resistance (AMR) is a global threat and serious public health concern. Resistance is directly related to antibiotic prescribing and trends in antibiotic consumption. Hence, it is imperative to conduct a comprehensive analysis of trends in antibiotic prescribing in an inpatient setting. Methods: This is a retrospective cohort study in which inpatient data on antibiotic utilization was abstracted from electronic health records of patients admitted to Aga Khan University Hospital, Karachi, Pakistan. Data on patient demographics, type, and the number of antibiotics prescribed were recorded from 2006 to 2019 to analyse the trends of antibiotic utilization. All the data were analyzed on STATA version 14. Findings: A total of 110,473 patients admitted to either pediatric or adult wards, were prescribed 686,020 antibiotics. The mean age in the pediatric group was 9.2 ± 4.5 years and in the adult group was 50.5 ± 19.0 years. Male to female ratio was 1:1. The most frequently utilized antibiotic were Ceftriaxone (45.4%), followed by Metronidazole (25.8%), Cefazolin sodium (24.9%), Piperacillin tazobactam (23.2%), Amoxicillin clavulanic acid (19.8%) and Cefixime (19.4%). Between 2006 and 2019, the prescription proportions of Ceftriaxone, Meropenem, Vancomycin, and Piperacillin tazobactam increased whereas that of Cefixime, Amoxicillin-clavulanic acid, Cefazolin sodium, and Metronidazole decreased over the time. Conclusion: Antibiotic utilization has increased at an alarming rate over time in hospitalized patients in our tertiary care center in Karachi, Pakistan. This has major implications for antibiotic resistance rates in our setting and highlights a pressing need for antibiotic stewardship efforts.