ANTIBIOTIC PRESCRIBING PATTERNS IN EMERGENCY AND OUTPATIENT DEPARTMENTS OF A TERTIARY CARE HOSPITAL

Background: Antibiotic misuse is a key driver of antimicrobial resistance (AMR), particularly in low—and middle-income countries where antibiotic stewardship practices are often limited. This study aimed to evaluate antibiotic prescribing patterns in a tertiary care hospital's emergency and outpatient departments in Pakistan. Methods: A retrospective observational study was conducted from January to March 2024 across four departments: Emergency, General OPD, IM Injection OPD, and IV Injection OPD. All patients who received antibiotics during this period were included. Data were collected from electronic records and manual prescription registers. Frequencies and percentages were used to analyze prescribing trends, most common diagnoses, and the route and type of antibiotics used. Results: Among 2,002 patients (53.15% male; 46.85% female), 44.66% visited solely to receive prescribed medication without a documented diagnosis. The most commonly reported conditions were upper respiratory tract infections (3.60%), acute gastroenteritis (2.95%), and sore throat (1.85%). Ceftriaxone was the most frequently prescribed antibiotic (14.79%), especially in injection form, followed by amoxicillin-clavulanic acid (8.99%) and cefixime (6.54%). Injectable antibiotics were heavily utilized in IV and IM OPDs even for non-severe cases and conditions with likely viral etiology. Conclusion: This study reveals a high prevalence of irrational antibiotic prescribing, including empirical use of broad-spectrum injectable antibiotics in outpatient and emergency settings. These practices may significantly contribute to antimicrobial resistance. Implementation of strict antibiotic stewardship programs and prescriber education is urgently needed to promote rational antibiotic use.