Antimicrobial Agent Utilization Pattern among Footballers in Eastern India: Classifying Using Access, Watch, and Reserve

Background: Vigorous training, practice-related injuries coupled with inadequate resting time puts athletes at risk of bacterial infections, which begets the use of antimicrobial agents. The present study was planned to observe and assess the antimicrobial utilization among footballers from various professional clubs in Eastern India. Materials and methods: A cross-sectional observational study was conducted to probe the professional footballers regarding the information on their AMA usage during the last 6 months. Data like name of AMAs, whether prescribed by physicians or taken up as over-the-counter (OTC) drugs, indications for consuming AMAs and consuming AMA for the recommended duration or not were taken into consideration. To assess the AMA utilization pattern, prescriptions and medical records available in respective clubs were thoroughly studied. Antimicrobial agent utilization was assessed based on AWaRe classification as laid down by the WHO. Results: Azithromycin (19.1%), ofloxacin plus ornidazole fixed-dose combination (17.3%) and amoxicillin plus clavulanic acid fixed-dose combination (11.1%) were the top three antibiotics consumed by them. Access, Watch, and Reserve (AWaRe) classification conferred 74% to be under “Watch” group, 22% “Access” and 4% “Reserve.” 62% (<italic>n</italic> = 68) of the total AMA consumers were prescribed an AMA, with a sore throat, upper and lower respiratory tract infection, effusion in the joint, cellulitis, prophylactic use in case of cut injury, loose motion, enteric fever, and skin infections being the common indications. And 71% of the AMA users were found not completing the AMA therapy as per the recommended/advised dosage schedule and duration. Conclusion: The knowledge on completing the recommended AMA course requires effective information dissemination. Antimicrobial agent prescribing pattern seen in this study revealed a high chance of development of resistance. Application of knowledge and principles of AWaRe classification thus need to be followed strictly by practitioners.