Original Research Article http://doi.org/ 10.18231/j.ijcaap.2019.006 IP International Journal of Comprehensive and Advanced Pharmacology, January-March 2019;4(1): 26-28 26 Antibiotic utilization pattern in the emergency medicine ward of a tertiary health care centre: An observational study Shambhu K. Yadav 1 , Monesh K. Likhitkar 2,* , Manish Kumar 3 , Lalit Mohan 4 , Harihar Dikshit 5 1 Senior Resident, 2 Patient Safety PV Associate, 3 Associate Professor, 4 Additional Professor, 5Professor and Head, 1-5 Dept. of Pharmacology, 1-5 IIndira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, Bihar, India *Corresponding Author: Monesh K. Likhitkar Email: mlikhitkar@yahoo.com Abstract Objective: Antibiotics are one of the most important discoveries in the field of medicine and are widely used in reducing the infections. The aim and objective of this study was to review utilization and assess the appropriateness of antimicrobial drug utilization in the medicine ward in a tertiary care hospital in Patna. This was a prospective observational study. Rationality of drug usage was also evaluated by analyzing the drug prescriptions. Materials and Methods: The data on antibiotic containing prescriptions from each patient was collected from the inpatient department and study was carried out from April to Jun, 2018. The data was collected on antibiotics was subjected for descriptive statistical analysis. Results: A total of 110 prescriptions were studied, out of which 69 (62.3%) prescriptions were mono therapy and 41(37%) prescriptions had multiple antibiotics. It was observed that out of 110 patients who were prescribed antibiotics, 61 were male (55.45%) and 49 were female (44.54%). The most commonly prescribed antibiotics were Ceftriaxone followed by ciprofloxacin and most of the prescriptions contained mono therapy. Conclusion: National guidelines for the management of common infections are needed to minimize the overuse and misuse of antimicrobial agents in tertiary care hospitals. Rational prescribing of antibiotics avoids poly-pharmacy and prevents antibiotic resistances. A large surveillance study on antimicrobial prescribing appropriateness in different hospital settings is warranted and aimed at adverse drug reaction, emergence of bacterial resistance, minimizing unnecessary cost. Keywords: Antibiotics, Drug utilization, Rational antibiotic use, Schedule H1. Introduction Poor prognosis of a situation, the main reason is infection. So adequate controlling of infections can prevent certain conditions which lead to mortality or morbidity which can be achieved by utilization of antibiotics. But unfortunately antibiotics also have effects. One is in treatment of infection; the other is the bacterial resistance. For a last decade, the problem of bacterial resistance is rising 1 . This led to the utilization of fixed dose combinations with multiple antibiotics in order to have a good control on bacterial infection. Antibiotics most important discoveries in the field of medicine and are mostly used in reducing the bacterial infections 2 . Antibiotic utilization is important as they are widely used drugs in treatment and health care and their inappropriate and excessive prescription and utilization in hospitals and health care facilities lead to the development of bacterial resistance 3 . The antibiotic use is very high in India and ranges from 24 to 67% 4 . Being the Asian country with highest burden of infectious disease in India has highest prescribing rate of antibiotic leading to their irrational and indiscriminate use which has resulted in increase in rate of antibiotic resistance 5 . For this purpose some guideline was published for the rational use of antibiotics are as follows 6 : 1. Prophylactic and empirical therapy of antibiotics should not be used unless and until in cases of emergency 2. Culture sensitivity tests of antibiotics should be done in order to avoid resistance. 3. Antibiotics are to be prescribed as per the spectrum of antibiotics 4. The dosage of antibiotics should be as per the patient conditions. A gradual increase in the dose is to be done in case if efficacy is not seen. 5. Parenteral therapy is advocated unless until it is necessary (where the patient is not able to take by oral route or in emergency conditions). Following of the above guidelines minimizes the effects with respect to the antibiotic resistance. Antibiotic utilization analysis is a tool to improve the rationality in prescribing which helps in monitoring the drug efficacy and other factors related to patient safety. It also plays a key role in reducing the adverse drug events occurs due to excessive use of antibiotic in Indian community 7 . Our present study of drug utilization aims to analyses about the antibiotic utilization to identify prescribing practices in emergency conditions and also in promoting rational use of drugs in the community. The present novelty of the study is, it specifies the utilization of antibiotics in the emergency medicine ward in respective hospital, and thereby caution the health care personals is which improves rationality and individual treatment regimen. Materials and Methods This observational and prospective study looked at antimicrobial utilization data in tertiary care hospital. An Institutional Ethical committee clearance (Letter no. 21/Acad./ Date-08/01/2018) was obtained to conduct the research. This research was conducted in emergency medicine ward at Indira Gandhi institute of medical science, Patna, which is super specialty tertiary care hospital of