Publication:

Antibiotic utilization evaluation of inpatient and outpatient prescriptions in a rural general hospital in Iran

Background High rate of antibiotic prescription is commonly encountered in hospital settings. Although the problem of the irrational use of antibiotics is particularly acute in rural health centers of developing countries, antibiotic utilization studies in such areas are scarce. In this study, we aimed to compare antibiotic prescription patterns between inpatients and outpatients in a rural general hospital.

Methods Inpatient and outpatient records were evaluated during a 1-month period. Data including patients’ demographics, length of hospital stay, final diagnosis, antibiotic regimen, dosing, rout of administration, microbiological culture/sensitivity tests and other laboratory data were retrieved from the hospital information system.

Results The number of prescriptions with at least one antibiotic was 686/1410 (48.6%) cases and 3812/6126 (62.2%) cases for inpatient and outpatient prescriptions, respectively. The mean number of antibiotic per prescription was 1.7±0.7 and 1.3±0.8 for inpatient and outpatients, respectively (p<0.05). Ceftriaxone had the highest rate of prescription among hospitalized patients with 791 (35.2%) times encounter while penicillin constituted the largest proportion of outpatient administrations with 2505 (29.8%) times. About 79% of inpatient and 62% of outpatient prescriptions containing final diagnosis data had the correct indication.

Conclusion Our study showed that implementation of strict regulations for antibiotic use is extremely needed in this rural hospital. Establishing local guidelines, providing adequate education for healthcare professionals and putting restrictions for broad-spectrum antibiotic use can be beneficial.