Antimicrobial Utilization, Adverse Drug Reactions, and Associated Cost of Care in a Tertiary Care Hospital in Eastern India

Background Antimicrobials considerably reduce infectious conditions, but their overuse and misuse contribute to various adverse drug reactions (ADRs) and antimicrobial resistance. In 2019, India adopted a national program to reduce antibiotic resistance for 2019-2021. Assessing antibiotic consumption among the out-patient and in-patient departments is paramount because it is the foundation for implementing and assessing antibiotic stewardship initiatives. This study aims to evaluate the usage pattern, ADR of antimicrobials and cost of treatment due to the use of antibiotics in patients admitted to selected departments of a tertiary care hospital in Eastern India. Material and methods An observational cross-sectional study was conducted on adult in-patients getting admitted to selected departments and ICUs of Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar. Data were collected using a convenience sampling method from 417 patients during July 2022 to January 2024. Study tools included the Case Record Form, WHO prescribing Indicators, and WHO Causality Assessment scale. Descriptive statistics were presented using frequencies and percentages. The chi-square test was done to analyze the associations among categorical variables. Results Middle-aged individuals had a higher likelihood of hospital admission and antibiotic administration. The gender distribution was almost equal in the study population. It was found that ceftriaxone was the most common antimicrobial used in Medicine 56 (18.5%) and Surgery 49 (18.2%) departments. In Orthopaedics and Obstetrics and Gynaecology (O&G) departments, the most common antimicrobials used were cefuroxime 37 (20.3%) and cefixime 32 (22.2%), respectively. Piperacillin-tazobactam 59 (16.3%) was the most frequently utilized antimicrobial in the ICU. The majority of the antibiotics 800 (65%) were prescribed from the Watch group of the WHO AWaRe Index. The cost of antimicrobial treatment was highest in the ICU and the least in the O&G department. None of the participants had any serious adverse effects related to antimicrobials. Conclusion The most common group of antimicrobials used in this study were beta-lactams. Ceftriaxone, cefuroxime, and piperacillin-tazobactam were the most common drugs prescribed. It was found that this study does not correspond with the optimal values of WHO core drug use prescribing indicators. None of the participants had any serious adverse effects related to antimicrobials.