KUMJ | VOL. 20 | NO. 3 | ISSUE 79 | JULY-SEPT. 2022
A Point Prevalence Study of the Use of Antibiotics in Six Tertiary Care Hospitals in the Kathmandu Valley, Nepal
Jha N, Thapa B, Pathak SB, Pandey A, Pokhrel S, Shankar PR, Bhandary S, Mudvari A, Dangal G
Abstract: Background
Point prevalence survey (PPS) on antibiotic use developed by the WHO has already
been used in many hospitals globally.
Objective
To obtain information on antibiotic prescribtion using point prevalence survey
methodology in six private hospitals in the Kathmandu valley.
Method
This descriptive cross-sectional study was completed during 20
th
July to 28
July
2021 using point prevalence survey methodology. The study was conducted among
inpatients admitted at or before 8:00 AM on the day of survey in various wards. Data
was presented as frequencies and percentages.
Result
Maximum number of patients were above 60 years [34 (18.7%)]. Number of male
and female participants were equal [91 (50%)]. Only one antibiotic was used in
81 patients (44.5%) followed by two antibiotics in 71 (39%) patients. Duration of
prophylactic antibiotic use was one day in 66 (63.7%) patients. Blood, urine, sputum,
and wound swabs were the common samples for culture. Cultures were positive for
17 (24.7%) samples. The common organisms isolated were E. Coli, Pseudomonas
aeruginosa and Klebsiella pneumoniae. Ceftriaxone was the most used antibiotic.
Drug and therapeutics, infection control committee and pharmacovigilance activities
were present in 3/6 (50%) study sites. Antimicrobial stewardship was present in 3/6
(50%) and microbiological services was present in all hospitals. Antibiotic formulary
and antibiotic guideline were present in 4/6 sites and facilities to audit or review
surgical antibiotic prophylaxis choice in 2/6 (33.3%) sites, facility to monitor antibiotic
use in 4/6 (66.6%) and cumulative antibiotic susceptibility reports in 2/6 (33.3%)
study sites.
Conclusion
Ceftriaxone was the most used antibiotic. E. Coli, Pseudomonas aeruginosa and
Klebsiella pneumonia were the commonly isolated organisms. Not all parameters
for infrastructure, policy and practice and monitoring and feedback were present at
the study sites.
Keyword : Antibiotics, Point prevalence survey, Private hospitals, Tertiary care centers
