title: Antibiotic sensitivity pattern and cost-effectiveness analysis of antibiotic therapy in an Indian tertiary care teaching hospital.
abstract: OBJECTIVE
  The purpose of this study is to analyze the antibiotic sensitivity pattern of microorganisms, to study the antibiotic usage pattern, and to conduct a cost-effectiveness analysis (CEA) for the antibiotics prescribed in a tertiary care teaching hospital in south India.
  
  
  METHODS
  This prospective study was carried out in the General Medicine and Pulmonology departments of the hospital for a period of 6 months. The study was carried out in three phases: A prospective analysis to check the sensitivity pattern of microorganisms to various antibiotics, data extraction and determining the cost of antibiotics and finally evaluation of the sensitivity pattern of microorganisms and the antibiotic usage. A total of 796 documented records were analyzed.
  
  
  RESULTS
  It was found that Escherichia coli was the major organism identified in 36.4% of the isolated specimens, followed by Klebsiella sp. (18.9%), Streptococcus pneumoniae (15.8%), Staphylococcus aureus (12.4%), and Pseudomonas (9.3%). The sensitivity pattern data of the prospective study revealed that E. coli was highly sensitive to Amikacin (99.3%), Klebsiella to Amikacin (93.8%), Pseudomonas to Meropenem (97.6%), and S. pneumoniae to Ofloxacin (93.8%). In the prescribing pattern study, it was found that the most common disease (21.2%) was found to be lower respiratory tract infection in 51 patients. Cephalosporins (73%), in particular Ceftriaxone (63.5%) was highly prescribed, followed by fluoroquinolones (53.9%). In the CEA, it was revealed that Ceftriaxone was the cost-effective antibiotic with a cost-effectiveness ratio (CER) of 78.27 compared to Levofloxacin, which had a CER of 95.13.
  
  
  CONCLUSIONS
  Continuous surveillance of susceptibility testing is necessary for cost-effective customization of empiric antibiotic therapy. Furthermore, reliable statistics on antibiotic resistance and policies should be made available.
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, SRIPMS, Coimbatore, Tamil Nadu, India.
authors.forename: Shamungum
authors.initials: S
authors.lastname: Sriram
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, SRIPMS, Coimbatore, Tamil Nadu, India.
authors.forename: Varghese
authors.initials: V
authors.lastname: Aiswaria
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, SRIPMS, Coimbatore, Tamil Nadu, India.
authors.forename: Annie Eapen
authors.initials: AE
authors.lastname: Cijo
authors.affiliation: Department of Pulmonology, Sri Ramakrishna Hospital, Coimbatore, Tamil Nadu, India.
authors.forename: Thekkinkattil
authors.initials: T
authors.lastname: Mohankumar
keywords: Antibiotics; cost-effectiveness analysis; prescribing pattern; sensitivity