Cephalosporin Utilization Pattern and Prescribing Trends in Gram-Negative Bacteria: Evidence for Facilitating Antimicrobial Stewardship

Background: India faces a high burden of infectious diseases globally, with Gram-negative bacteria posing a major threat. Cephalosporins are commonly used to treat these infections, but focused data on their utilization for Gram-negative infections is scarce, hindering targeted treatment and antimicrobial stewardship efforts. Our study aims to address this by providing comprehensive data on cephalosporin use for Gram-negative infections, promoting rational drug use, and enhancing antimicrobial stewardship practices. Methods: A prospective observational study was conducted in Chennai from July to October 2024, to evaluate cephalosporin use in Gram-negative infections. The study enrolled 126 patients aged 20-70 prescribed cephalosporins, either empirically or on definitive therapy based on culture results. Data on demographics, diagnoses, culture reports, and treatment were recorded, categorized as empirical or definitive, and analyzed using chi-square tests (p < 0.05). Results: The analysis showed a significant preference for third-generation cephalosporins in empiric and definitive therapy, confirmed by substantial deviations from expected distributions (p < 0.05), with cefoperazone with sulbactam being the most frequently prescribed in empirical treatment. Conclusion: The study reveals the predominant use of third-generation cephalosporins in treating Gram-negative infections, emphasizing the need for antimicrobial stewardship, stricter guidelines and treatment protocols to include definitive therapies, and promoting rational drug use by adhering to antibiotic policies to combat resistance. Keywords: Cephalosporin, Gram-negative infection, Drug Utilization, Prescribing pattern, antimicrobial stewardship.