A study on practices of antibiotics prescription among doctors in medical and surgical wards of Teaching Hospital Batticaloa

Abstract

Antibiotics are substances produced by microorganisms, which selectively suppress the growth of or kill other microorganisms. Antibiotic resistance refers to the unresponsiveness of a microorganism to an antibiotic drug. Acquired resistance arises largely through the misusing, inadequate use or overusing of antibiotics. Any occasion where the antibiotics are used, it contributes to antibiotic resistance. So, doctors must be concerned about both the benefit to the patient and risk of antibiotic resistance while prescribing antibiotics. The objective of the study is to describe the practices of antibiotic prescription among doctors in Medical and Surgical wards of Teaching Hospital Batticaloa. Descriptive, cross-sectional study, was conducted among Doctors in Medical and Surgical wards of Teaching Hospital Batticaloa using a questionnaire via Google form. Variables were analyzed using SPSS.26. A total of 68 doctors out of 90 doctors from Medical and Surgical wards of Teaching Hospital Batticaloa (75.6% of total population) participated in our study. From total participants 67.64% adhering to guidelines when they prescribe antibiotics. Majority (89.3%) adhere to National Guidelines. When assessing reason for not adhering to guidelines among 28 responders 22 doctors’ (78.57%) response was they prescribe according to the availability of drugs. Among the responders who responded to the ‘factors affecting antibiotic prescription’ question, 56.3% find it is difficult to assess renal and liver function before prescribing antibiotics. 30.88% of responders request bacterial cultures before starting empiric antibiotic therapy and 80.6% find it is difficult to get the culture bottles on time. Though 98.5% of participants shift from empiric to targeted therapy according to culture report, only 19.1% shift from empiric to targeted therapy according to the culture report if patient clinically responds to empiric therapy. Unavailability of culture reports on time is the challenge that 61.7% of participants face when shifting from empiric to targeted therapy. 94.12% of participants check the duration of antibiotic therapy in routine ward round and 97.1% trace the culture reports during the ward rounds. Our study concludes that the majority of the doctors adhere to guidelines, among them majority adhere to National guidelines and prescription according to the availability of drugs is an important fact for not adhering to guidelines. Our findings showed that, inability to assess renal and liver functions before prescribing antibiotics is a major affecting factor while prescribing antibiotics and difficulty to get culture bottles on time is the challenge majority of doctors face while requesting cultures before starting empiric antibiotic therapy. According to the responders, majority found it is difficulty to shift from empiric to targeted antibiotic therapy due to unavailability of culture reports on time and majority of the doctors are not shifting from empiric to targeted antibiotic therapy if the patient is clinically responding to empiric antibiotic therapy. This indicates the higher chance of patients being on high potent broad spectrum empiric antibiotics for longer duration. These issues need to be addressed by the relevant authorities to facilitate rational prescription of antibiotics.