Open AccessAnnual consumption of parenteral antibiotics in a tertiary hospital of Nepal, 2017–2019: a cross-sectional study
Author(s) -
Prakash Baral,
Katrina Hann,
Bhishma Pokhrel,
Tapendra Koirala,
Raj Kumar Thapa,
Sanjeev M Bijukchhe,
Mohammed Khogali
Publication year - 2021
Publication title -
public health action
Language(s) - English
Resource type - Journals
ISSN - 2220-8372
DOI - 10.5588/pha.21.0043
Subject(s) - medicine , antibiotics , meropenem , defined daily dose , enteral administration , ceftriaxone , cross sectional study , subgroup analysis , parenteral nutrition , tertiary care , emergency medicine , pediatrics , antibiotic resistance , intensive care medicine , medical prescription , pharmacology , microbiology and biotechnology , pathology , biology , confidence interval
SETTING: Patan Hospital, a tertiary care hospital in Lalitpur District, Nepal. OBJECTIVES: To describe the annual parenteral antibiotic consumption in 1) defined daily dose (DDD) and DDD per 100 admissions; 2) calculate DDD per 100 admissions and proportions by pharmacological subgroup, chemical subgroup and AWaRe categories; and 3) describe patient expenditure on parenteral antibiotics as a proportion of the total patient expenditure on drugs and consumables between 2017 and 2019. DESIGN: This was a cross-sectional study. RESULTS: Total DDD of parenteral antibiotics increased by 23% from 39,639.7 in 2017 to 48,947.7 in 2019. DDD per 100 admissions increased by 10% from 172.1 in 2017 to 190.2 in 2019. Other beta-lactam antibacterials comprised the most frequently consumed pharmacological subgroup. The chemical substance most often consumed was ceftriaxone, with an increasing trend in the consumption of vancomycin and meropenem. Parenteral antibiotics in ‘Watch’ category were the most consumed over the study period, with a decreasing trend in ’Access’ and increasing trend in ‘Reserve’ categories. CONCLUSION: We aimed to understand the consumption of parenteral antibiotics at a tertiary care hospital and found that Watch antibiotics comprised the bulk of antibiotic consumption. Overconsumption of antibiotics from the ‘Watch’ and ‘Reserve’ categories can promote antimicrobial resistance; recommendations were therefore made for their rational use.