Evidence map›Paper›PMID 39524176›Full record

ArticleCureus2024

Antibiotic Prescribing Practices in a Tertiary Care Teaching Hospital: A Retrospective Cross-Sectional Analysis.

Usman Zafar, Ashir Iqbal, Abdul Basit, Muhammad S Ahmed, Hafiz Muddassir Imtiaz, Ferwa Asif, Moiz N Butt, Ahmed Faraz, Sundas N Butt, Muhammad A Awan

Abstract read
In one paragraph

Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Usman ZafarDepartment of Medicine, Dr. Akbar Niazi Teaching Hospital, Islamabad, PAK.
Ashir IqbalInternal Medicine, Alkhidmat Raazi Hospital, Rawalpindi, PAK.
Abdul BasitFamily Medicine, Alkhidmat Raazi Hospital, Rawalpindi, PAK.
Muhammad S AhmedGeneral Medicine, Dr. Akbar Niazi Teaching Hospital, Islamabad, PAK.
Hafiz Muddassir ImtiazGeneral Medicine, Dr. Akbar Niazi Teaching Hospital, Islamabad, PAK.
Ferwa AsifCardiothoracic Surgery, Guy's and St Thomas' NHS Foundation Trust, London, GBR.
Moiz N ButtInternal Medicine, Alkhidmat Raazi Hospital, Rawalpindi, PAK.
Ahmed FarazEmergency Medicine, Cambridge University Hospitals, Cambridge, GBR.
Sundas N ButtGeneral Surgery, Dr. Akbar Niazi Teaching Hospital, Islamabad, PAK.
Muhammad A AwanFamily Medicine, Alkhidmat Raazi Hospital, Rawalpindi, PAK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Antibiotics are among the most frequently prescribed medications in hospitals, yet a significant portion of their use is inappropriate, contributing to the growing global threat of antimicrobial resistance (AMR). In Pakistan, AMR has reached alarming levels with the rise of multi- and extensively drug-resistant bacteria. This study evaluates antibiotic prescribing practices and the use of culture sensitivity (CS) testing to assess the appropriateness of antibiotic therapy. Methods This cross-sectional retrospective study was conducted in a 500-bed tertiary care teaching hospital in Islamabad, Pakistan, analyzing inpatient records from 2020 to 2022. From over 5000 patient files, 1012 met the inclusion criteria and were reviewed. The study assessed the rationality of antibiotic prescriptions based on the evidence of infection (EoI), clinical parameters, and the presence or absence of CS testing. Statistical analyses, including Chi-square tests, logistic regression, and Cox proportional hazards regression, were applied to determine the association between antibiotic use and patient outcomes. Results Among the 1,012 patients analyzed, 91.8% (n = 929) received one or more antibiotics. However, 30% (n = 274) of these prescriptions were issued without any documented EoI. Only 17.5% of patients underwent CS testing. Patients exposed to five or more antibiotics had a 2.5-fold increased risk of ICU mortality (HR = 2.50, p < 0.001). A positive correlation (r = 0.42, p < 0.001) was found between the number of antibiotics prescribed and the length of hospitalization. Conclusion The findings of this study reveal a high rate of inappropriate antibiotics prescribed without EoI and CS testing. The results emphasize the urgent need for comprehensive Antibiotic Stewardship Programs (ASPs) in hospital settings, particularly focusing on mandatory CS testing protocols. By reducing irrational antibiotic use, these initiatives can significantly mitigate the rise of AMR globally, especially in resource-limited settings. Implementing ASPs not only optimizes antibiotic use but also aligns with the WHO recommendations, demonstrating the effectiveness of multifaceted interventions in minimizing resistance and improving patient outcomes.

Indexed as

antibiotic prescribing practicesantibiotic stewardship programsantimicrobial resistanceculture sensitivity testingevidence of infectionrational use of antibiotics

Identifiers

PMID39524176
PMCPMC11543378

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.