title: Patterns of Antimicrobial Prescribing in a Tertiary Care Hospital in Oman.
abstract: OBJECTIVE
  Antimicrobial stewardship programs have been designed to measure and improve the use of antimicrobials to achieve optimal clinical outcomes and reduce bacterial resistance. The aim of this study was to review patterns of antimicrobial prescribing for hospitalized patients in the acute care setting and assess the appropriateness of antimicrobial use among prescribers in a tertiary care hospital in Oman.
  
  
  METHODS
  We conducted a retrospective audit of the appropriateness of antimicrobial prescribing in patients admitted to acute care settings in a tertiary care hospital in Oman over a four-week period (1 November to 28 November 2012). The data of all discharged patients were retrieved from the department databases. Patient records and prescriptions were reviewed by an infectious disease consultant. The rationality of antimicrobial use was evaluated, analyzed, and judged based on local standard guidelines and the experience of the evaluating consultant.
  
  
  RESULTS
  There were 178 patients discharged from acute medical teams over the study period. Sixty-four percent of the patients received a total of 287 antimicrobial agents during admission. The average number of antimicrobials prescribed per patient in those prescribed antimicrobials was 2.5±1.1. The most commonly prescribed antimicrobial agent was piperacillin/tazobactam. Most patients had infections from gram-negative organisms, and high rates of extended spectrum beta-lactamase producing organisms were observed. Cultures were obtained before antimicrobial initiation in 25% of patients. Variability in antimicrobial selection for common infections was observed.
  
  
  CONCLUSIONS
  National guidelines for the management of common infections are needed to minimize the overuse and misuse of antimicrobial agents in tertiary care hospitals. A large surveillance study on antimicrobial prescribing appropriateness in different hospital settings is warranted.
authors.affiliation: Internal Medicine Resident, Oman Medical Specialty Board, Muscat, Oman.
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Al-Yamani
authors.affiliation: Department of Internal Medicine, Royal Hospital, Muscat, Oman.
authors.forename: Faryal
authors.initials: F
authors.lastname: Khamis
authors.affiliation: Department of Pharmacology and Clinical Pharmacy, Sultan Qaboos University, Muscat, Oman.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Al-Zakwani
authors.affiliation: Department of Pharmacy, Royal Hospital, Muscat, Oman.
authors.forename: Hamed
authors.initials: H
authors.lastname: Al-Noomani
authors.affiliation: Department of Nursing, Royal Hospital, Muscat, Oman.
authors.forename: Jaleela
authors.initials: J
authors.lastname: Al-Noomani
authors.affiliation: Department of Internal Medicine, Royal Hospital, Muscat, Oman.
authors.forename: Seif
authors.initials: S
authors.lastname: Al-Abri
keywords: Anti-Bacterial Agents; Antimicrobial agents; Arabs; Inappropriate Prescribing; Oman
references.citation: S Afr Med J. 1991 Jul 6;80(1):7-10
references.pmid: 2063250
references.citation: Oman Med J. 2011 May;26(3):205-6
references.pmid: 22043418
references.citation: J Antimicrob Chemother. 2008 Oct;62(4):830-6
references.pmid: 18593724
references.citation: Antimicrob Resist Infect Control. 2012 Jul 19;1(1):26
references.pmid: 22958584
references.citation: Avicenna J Med. 2011 Jul;1(1):8-11
references.pmid: 23210003
references.citation: Rev Infect Dis. 1990 Jan-Feb;12(1):136-41
references.pmid: 2300735