title: Antimicrobial use and antimicrobial resistance in nosocomial pathogens at a tertiary care hospital in Pune.
abstract: BACKGROUND
  Resistance to antimicrobial agents is emerging in wide variety of nosocomial and community acquired pathogens. Widespread and often inappropriate use of broad spectrum antimicrobial agents is recognized as a significant contributing factor to the development and spread of bacterial resistance. This study was conducted to gain insight into the prevalent antimicrobial prescribing practices, and antimicrobial resistance pattern in nosocomial pathogens at a tertiary care hospital in Pune, India.
  
  
  METHODS
  Series of one day cross sectional point prevalence surveys were carried out on four days between March and August 2014. All eligible in patients were included in the study. A structured data entry form was used to collect the data for each patient. Relevant samples were collected for microbiological examination from all the clinically identified hospital acquired infection cases.
  
  
  RESULTS
  41.73% of the eligible patients (95% CI: 39.52-43.97) had been prescribed at least one antimicrobial during their stay in the hospital. Beta-lactams (38%) were the most prescribed antimicrobials, followed by Protein synthesis inhibitors (24%). Majority of the organisms isolated from Hospital acquired infection (HAI cases) were found to be resistant to the commonly used antimicrobials viz: Cefotaxime, Ceftriaxone, Amikacin, Gentamicin and Monobactams.
  
  
  CONCLUSIONS
  There is need to have regular antimicrobial susceptibility surveillance and dissemination of this information to the clinicians. In addition, emphasis on the rational use of antimicrobials, antimicrobial rotation and strict adherence to the standard treatment guidelines is very essential.
authors: Senior Consultant (Medicine), O/O DGAFMS, Ministry of Defence, M Block, New Delhi 110001, India.
authors: Velu
authors: V
authors: Nair
authors: Professor, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India.
authors: Dinesh
authors: D
authors: Sharma
authors: Commandant, 174 Military Hospital, C/O 56 APO, India.
authors: A K
authors: AK
authors: Sahni
authors: Associate Professor, Department of Microbiology, Armed Forces Medical College, Pune 411040, India.
authors: Naveen
authors: N
authors: Grover
authors: Senior Advisor (Medicine), Command Hospital (Air Force), Bengaluru, India.
authors: S
authors: S
authors: Shankar
authors: Associate Professor, Department of Surgery, Armed Forces Medical College, Pune 411040, India.
authors: S S
authors: SS
authors: Jaiswal
authors: Associate Professor, Department of Paediatrics, Armed Forces Medical College, Pune 411040, India.
authors: S S
authors: SS
authors: Dalal
authors: Scientist 'F', Department of Community Medicine, Armed Forces Medical College, Pune 411040, India.
authors: D R
authors: DR
authors: Basannar
authors: Resident, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India.
authors: Vivek S
authors: VS
authors: Phutane
authors: Commandant, 153 General Hospital, C/O 56 APO, India.
authors: Atul
authors: A
authors: Kotwal
authors: Honorary Senior Lecturer, Imperial College, London, UK.
authors: G
authors: G
authors: Gopal Rao
authors: Consultant, London North West Healthcare NHS Trust, London, UK.
authors: Deepak
authors: D
authors: Batura
authors: Dean & Deputy Commandant, Armed Forces Medical College, Pune 411040, India.
authors: M D
authors: MD
authors: Venkatesh
authors: DGMS (Navy), IHQ MoD (Navy), New Delhi 110001, India.
authors: Tapan
authors: T
authors: Sinha
authors: Director and Commandant, Armed Forces Medical College, Pune 411040, India.
authors: Sushil
authors: S
authors: Kumar
authors: Ex-DGAFMS, O/o DGAFMS, New Delhi 110001, India.
authors: D P
authors: DP
authors: Joshi
keywords: Antibiotic sensitivity; Antifungal sensitivity; Antimicrobial use; Hospital acquired infection; Microorganisms