The assessment of antibiotic utilization among geriatric patients in a tertiary care center using WHO AWaRe antibiotic guideline- A retrospective study | ||||
| Microbes and Infectious Diseases | ||||
| Articles in Press, Accepted Manuscript, Available Online from 30 April 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mid.2025.367935.2627 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Goutam Gopakumar 1; Dawn Anthony 2; Dona Basil 1; Anjali Saji 1; Merrin Joseph  1
| ||||
| 1Department of Pharmacy Practice, Nirmala College of Pharmacy, Muvattupuzha, Ernakulam, Kerala, India – 686661 affiliated to Kerala University of Health and Science, Medical College PO, Thrissur, Kerala, Pin: 680596, India | ||||
| 2Department of General Medicine, MOSC Medical College Hospital, Kolenchery, Ernakulam, Kerala, India -682311 affiliated to Kerala University of Health and Science, Medical College PO, Thrissur, Kerala, Pin: 680596, India | ||||
| Abstract | ||||
| Aim: To assess the pattern of antibiotic utilization and resistance among geriatric inpatients diagnosed with UTI or LRTI, using WHO AWaRe guidelines, over a 6-month period in a tertiary care center in Kerala. Methods: A retrospective, observational study was conducted in General Medicine, Pulmonology departments in patients aged above 60 years, those receiving at least one antibiotic during their inpatient stay. The patient demographic details and clinical details including the diagnosis, name of the antibiotic, dose, indication, frequency, route of administration was collected. To assess the absolute deviation of PDD from DDD, a one-sample t-test was conducted, employing a test value of zero. For all test p value < 0.05 was considered as statistically significant. Results: Among 348 antibiotics prescribed, the majority fall under the WATCH classification, constituting 79.6% of all cases. The study revealed a high rate of empirical antibiotic use among geriatric patients (69%). For UTIs, Piperacillin/tazobactam, administered had a mean DDD of 11.05g and demonstrated significant statistical relevance. In the case of LRTIs, Piperacillin/tazobactam showed a mean DDD of 11.89g with a significant p-value. Concerning trends was identified when antibiotic resistance patterns were analyzed; ampicillin showed a 39.4% resistance rate against UTIs linked to E coli. Conclusion: The study identified a predominant use of WATCH category antibiotics (79.6%) and a high rate of empirical prescribing (69%) among geriatric inpatients with UTIs and LRTIs, highlighting deviations from WHO AWaRe guidelines and underscoring the urgent need for targeted antimicrobial stewardship interventions in the vulnerable, geriatric population. | ||||
| Keywords | ||||
| LRTI; UTI; Elderly; Defined Daily Dose; Antimicrobial resistance | ||||
|
Statistics Article View: 143 |
||||
