: Background: Patients admitted to obstetrics and gynaecology (OBGY) departments are at high risk of infections and subsequent antibiotic prescribing, which may contribute to antibiotic resistance (ABR). Although antibiotic surveillance is one of the cornerstones to combat ABR, it is rarely performed in low- and middle-income countries. Aim: To describe and compare antibiotic prescription patterns among the inpatients in OBGY departments of two tertiary care hospitals, one teaching (TH) and one nonteaching (NTH), in Central India. Methods: Data on patients’ demographics, diagnoses and prescribed antibiotics were collected prospectively for three years. Patients were divided into two categories- infectious and non-infectious diagnosis and were further divided into three groups: surgical, nonsurgical and possible-surgical indications. The data was coded based on the Anatomical Therapeutic Chemical classification system, and the International Classification of Disease system version-10 and Defined Daily Doses (DDDs) were calculated per 1000 patients. Results: In total, 5558 patients were included in the study, of those, 81% in the TH and 85% in the NTH received antibiotics (p < 0.001). Antibiotics were prescribed frequently to the inpatients in the nonsurgical group without any documented bacterial infection (TH-71%; NTH-75%). Prescribing of broad-spectrum, fixed-dose combinations (FDCs) of antibiotics was more common in both categories in the NTH than in the TH. Overall, higher DDD/1000 patients were prescribed in the TH in both categories. Conclusions: Antibiotics were frequently prescribed to the patients with no documented infectious indications. Misprescribing of the broad-spectrum FDCs of antibiotics and unindicated prescribing of antibiotics point towards threat of ABR and needs urgent action. Antibiotics prescribed to the inpatients having nonbacterial infection indications is another point of concern that requires action. Investigation of underlying reasons for prescribing antibiotics for unindicated diagnoses and the development and implementation of antibiotic stewardship programs are recommended measures to improve antibiotic prescribing practice.

中文翻译：

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印度中部两家三级医院妇产科住院的感染性和非感染性症状患者的抗生素处方。


：背景： 妇产科 (OBGY) 收治的患者感染和随后服用抗生素的风险很高，这可能会导致抗生素耐药性 (ABR)。尽管抗生素监测是对抗 ABR 的基石之一，但在低收入和中等收入国家却很少进行。 目的： 描述和比较印度中部两家三级医院（一家教学医院 (TH) 和一家非教学医院 (NTH)）妇产科住院患者的抗生素处方模式。 方法： 数据于 前瞻性地收集了三年来患者的人口统计数据、诊断和处方抗生素。患者被分为两类——感染性和非感染性诊断，并进一步分为三组：手术、非手术和可能手术指征。数据根据解剖治疗化学分类系统进行编码，并计算每 1000 名患者的国际疾病分类系统第 10 版和规定每日剂量 (DDD)。结果： 该研究总共纳入了 5558 名患者，其中 81% 的 TH 患者和 85% 的 NTH 患者接受了抗生素治疗（p < 0.001）。没有任何细菌感染记录的非手术组住院患者经常服用抗生素（TH-71%；NTH-75%）。在 NTH 中，广谱、固定剂量组合 (FDC) 抗生素的处方在这两个类别中比在 TH 中更常见。总体而言，在这两个类别中，TH 中的 DDD/1000 名患者均较高。 结论： 经常给没有记录的感染迹象的患者开抗生素。广谱抗生素 FDC 的错误处方和未经指示的抗生素处方都可能面临 ABR 的威胁，需要采取紧急行动。给有非细菌感染指征的住院患者开抗生素是另一个需要采取行动的关注点。调查为不明原因的诊断开抗生素的根本原因以及制定和实施抗生素管理计划是改善抗生素处方实践的建议措施。