title: Antibiotic prescribing in medical intensive care units--a comparison between two private sector hospitals in Central India.
abstract: BACKGROUND
  Inappropriate antibiotic prescribing, common in India, contributes to increased risk for development of bacterial resistance. Patients admitted to intensive care units (ICUs) are often prescribed antibiotics. Paucity of local data on antibiotic prescribing hinders development of appropriate interventions. The aim of the study was to describe and compare antibiotic prescribing in medical ICUs (MICUs) at two private sector hospitals, one teaching (TH) and one non-teaching (NTH) in Ujjain, India.
  
  
  METHODS
  The study was conducted prospectively for 3 years at MICUs of both hospitals. Patients were compared for demographic variables and diagnosis, prescribed antibiotics, generic name prescribing, and route of administration. Adherence to the World Health Organization list of essential medicines (WHOLEM) and the National List of Essential Medicines of India (NLEMI) was analyzed.
  
  
  RESULTS
  In total, 4843 of 6141 patients admitted to the MICUs stayed at least one night. More than 70% were prescribed antibiotics. Generic name prescribing was more common at the TH than at the NTH. Prescriptions at the TH had higher compliance to WHOLEM and NLEMI compared with that at the NTH (p < 0.001). Of the 1371 patients at the TH, 189 (14%) and of 3472 at the NTH, 400 (12%) patients were diagnosed with infections. More than 75% of patients at both hospitals had no infection-associated diagnoses.
  
  
  CONCLUSIONS
  Antibiotic prescribing was common at both hospitals. The antibiotic prescriptions at the TH had higher compliance to WHOLEM and NLEMI. However, there is a need to develop appropriate interventions to improve antibiotic prescribing at both hospitals.
authors.affiliation: From the Department of Pharmacology, Ruxmaniben Deepchand Gardi Medical College , Ujjain , India.
authors.forename: Megha
authors.initials: M
authors.lastname: Sharma
authors.forename: Anna L
authors.initials: AL
authors.lastname: Damlin
authors.forename: Ashish
authors.initials: A
authors.lastname: Sharma
authors.forename: Cecilia
authors.initials: C
authors.lastname: Stålsby Lundborg
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D016304:Hospitals, Private; D006801:Humans; D057970:Inappropriate Prescribing; D007194:India; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D055656:Prescriptions; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic prescribing; inpatients; medical intensive care unit; private sector hospitals; teaching and non-teaching hospitals