: 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的妇产科允许有感染和非感染适应症患者的抗生素处方。

：背景： 考上妇产科（OBGY）部门患者有感染和随后的抗生素治疗，这可能有助于抗生素耐药性（ABR）的高风险。尽管抗生素监测是抗击ABR的基础之一，但在中低收入国家很少进行这种监测。 目的： 描述和比较印度中部两家三级护理医院（一门教学（TH）和一门非教学（NTH））的OBGY部门住院患者的抗生素处方方式。 方法： 数据 对患者的人口统计学，诊断和处方抗生素进行了前瞻性收集，为期三年。将患者分为传染性和非传染性诊断两类，并进一步分为三类：手术，非手术和可能手术适应症。数据是根据“解剖治疗化学”分类系统进行编码的，每1000名患者计算国际疾病分类系统版本10和“每日定义剂量”（DDD）。结果： 总共有5558名患者被纳入研究，其中TH中81％的患者和NTH中85％的患者接受了抗生素治疗（p <0.001）。非手术组的住院患者经常开抗生素，没有任何细菌感染的记录（TH-71％； NTH-75％）。在NTH中，广谱，固定剂量的抗生素处方（FDC）在NTH中比在TH中更为常见。总体而言，在这两个类别的TH中都开出了较高的DDD / 1000患者处方。 结论： 经常给患者开抗生素，但没有任何传染病迹象。抗生素的广谱FDC处方错误以及未明确指示的抗生素处方都将威胁ABR，因此需要紧急行动。给住院患者开具非细菌感染指征的抗生素是需要采取行动的另一个关注点。建议采取措施调查未明确诊断的抗生素处方的根本原因，以及制定和实施抗生素管理计划，这些措施可改善抗生素处方实践。