Evaluation of Antibiotics Used for Lower Respiratory Tract Infections in a Tertiary Care Hospital

Abstract

Objective: The main objective of the study was to evaluate patterns of antibiotics prescribed for Lower respiratory tract infections (LRTIs) in a tertiary care hospital. Methodology: A prospective observational study was conducted in the pulmonology and general medicine departments of a tertiary care hospital. The data was collected from the in- patient department after considering inclusion and exclusion criteria for a period of 6 months. Antibiotics prescribed were compared with the guidelines mentioned in the European respiratory society guidelines (ERS), Indian respiratory guidelines, IDSA guidelines, and NICE guidelines to determine the appropriateness of therapy. Statistical tools like Chi-square test were applied to the data by using SPSS software. Result: A total of 284 patients diagnosed with various LRTIs, male 55% patients predominated over female patients of 45%. The majority of the patients were under age group of 61-70 years (24%), literates (71.84%), and symptoms of SOB (88.73%), Cough (69.01%), generalized weakness/body pains (54.92%), fever (50.70%), wheeze (11.26%) and chest pain (9.85%). Among all cases of LRTI, most of the patients 56.4% were diagnosed with viral pneumonia (COVID-19). Higher number of patients was treated with beta-lactam antibiotics. Inj.Piperacillin/tazobactum (38%), Tab.Cefpodoxime proxetil/Clavulanic acid (41%), Inj.Cefaperazone/Sulbactum (35%) and Inj.Amoxicillin/Clavulanic acid (23%) were frequently used. Conclusion: Lower respiratory tract infections are mostly seen in males, elder age groups and in literate patients. Present study showed that the antibiotics were used taking into consideration various clinical and diagnostic evidences like radiology, bio-markers, patient condition and severity of the disease. However the establishment of antibiotic stewardship program is necessary to ensure safe and appropriate use of antibiotics and to prevent antibiotic resistance in patients.