Evaluation of Antibiotics Prescribing Patterns at a Tertiary Care Teaching Hospital Using WHO AWaRe Classification

Author(s): Damini Prajapati, Shah Megha H, Desai Chetna K

Antimicrobial resistance (AMR) is a global health challenge driven by the misuse and overuse of antibiotics. Two key initiatives taken by World Health Organization (WHO) to promote rational antibiotic use and address AMR include updating the Essential Medicines List (EML) and implementing the Access, Watch and Reserve (AWaRe) classification. This study aimed to assess the antibiotic prescribing patterns at a tertiary care teaching hospital. A 12-month observational, prospective study was conducted on indoor patients from the Medicine, Surgery, and Obstetrics & Gynecology wards. Data were collected on the 2nd and 7th days of antibiotic therapy. Antibiotic use was grouped into Access, Watch, Reserve and Not Recommended groups. The mean age of patients was 40.54 years (52% were female). A total of 983 antibiotics were prescribed among 600 patients, with the Watch group (59.82%) being the most common, followed by Access (31.64%) and Reserve group antibiotics(1.93%).Ceftriaxone was the most frequently prescribed antibiotic (24.42%). The Access to Watch ratio was 0.5. Empirical antibiotic use was high (42%), while 1.33% were based on culture sensitivity. Adherence to the NLEM was 90.69% in Medicine, 72.09% in Surgery, and 87.01% in Obstetrics & Gynecology. The study revealed a high reliance on Watch antibiotics, with ceftriaxone being the most prescribed.