title: Pattern of antibiotics usage in a community hospital of Malwa region of Punjab, India.
abstract: To assess the pattern of antibiotic utilisation and outcome of patients with bacteraemia in the hospital. All positive blood cultures (BC) over a 12-month period from January 2011 to December 2011 were retrospectively reviewed. Positive BC were recorded in 54 patients. 51.9% of the patients received antibiotics before or soon after obtaining the BC, and ceftriaxone was the most frequently-prescribed antibiotic (42.9%), either alone or in combination with other antibiotics. The bacteraemia was due to gram-negative rods in 84.9% and gram-positive cocci in 15.1% of cases. Most common gram-negative bacilli were E. coli, Klebsiella pneumoniae and Salmonella species while most common gram-positive cocci was Staphylococcus aureus. Antibiotics regimen was changed in 37% cases after BC results became available. Most frequent change was addition of meropenem in case of gram-negative bacilli (29.6%) and vancomycin in gram-positive cocci (12.5%).Ten (18.5%) patients developed serious sepsis or septic shock; 3 (30.0%) improved and 7(70.0%) had fatal outcome. Antibiotic selection needs tobe tailor made for each patient. However, most bacteraemia necessitating hospital admission are due to gram-negative bacilli and it should be considered in antibiotic selection prior to BC.
authors.forename: Kanu
authors.initials: K
authors.lastname: Goel
authors.forename: Sandeep
authors.initials: S
authors.lastname: Gupta
authors.forename: Honey
authors.initials: H
authors.lastname: Rani
authors.forename: Bhavna
authors.initials: B
authors.lastname: Singla
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy* / Q000453:epidemiology; D002443:Ceftriaxone / Q000627:therapeutic use; D003906:Developing Countries; D057915:Drug Substitution / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone