Affiliations: Amrita Institute of Medical Sciences, Kochi, Kerala,
India | Department of Clinical Microbiology, University of
Antwerp, Antwerp, Belgium | BL Kapoor Hospital, New Delhi, India | Paediatric Infectious Diseases Research Group, St
George¡¯s University of London, London, UK
Note: [] Correspondence: Dr. Sanjeev Singh, A 12, EKTA, Amrita Institute
of Medical Sciences, Ponekara, Kochi, 682041, India. Tel.: +91 484 2801234;
Fax: +91 484 2802121; E-mail: sanjeevksingh@aims.amrita.edu
Abstract: Point prevalence surveys (PPS) have been used to document
antimicrobial use in healthcare organizations. Antimicrobial resistance is a
global concern, more so for developing countries like India, where the burden
of antimicrobial resistance and infectious diseases are very high. A web based
PPS developed by University of Antwerp, Belgium for the Antibiotic Resistance
and Prescribing in European Children (ARPEC) project was used to enter data
from pediatric and neonatal wards and intensive care units (ICU) from 8 centers
across India. All patients who were receiving systemic antibacterial treatments
on the day of the survey inclusive of antibacterial prophylaxis for surgery
were included. 195 patients were surveyed across India: 105 (54%) medical and
90 (46%) surgical. 192 (98%) patients received multiple antimicrobials out of
which 187 (95%) were given parenterally. Empirical antimicrobials were
prescribed in 138 (71%) patients and targeted therapy in 57 (29%). The
commonest infections for which antimicrobials were prescribed were healthcare
associated infections 180 (41.76%) followed by surgical prophylaxis 90 (21%)
and community acquired infections 84 (18%). Antimicrobials usage was maximal
in ICUs. More than a single dose (5.6%) for more than a day (86.7%) was used
for surgical prophylaxis. The Web based PPS suggests widespread antibiotic
usage among pediatric and neonatal patients in selected tertiary Indian
hospitals and underscores the need for antibiotic stewardship in order to
promote rational and evidence based practice to limit the emergence of
antibiotic resistant microbes.
Keywords: Point prevalence surveys, antimicrobial resistance, prophylaxis
