Comprehensive Antibiotic Drug Resistance Surveillance and Antibiotic Utilisation Review: A Prospective Observational Study

This prospective observational study was conducted over a six-month period in a tertiary care teaching hospital to evaluate antibiotic resistance patterns and review antibiotic utilization among inpatients. A total of 364 clinical samples from patients aged 18 to 70 years were analyzed to identify priority pathogens and assess their resistance profiles. Gram-negative bacilli such as Escherichia coli, Klebsiella species, and Pseudomonas aeruginosa showed high resistance to cephalosporins, aminoglycosides, and fluoroquinolones, with some strains exhibiting resistance even to last-resort drugs like carbapenems. Alarmingly, emerging resistance was also noted in traditionally sensitive organisms, including reduced susceptibility to piperacillin-tazobactam and linezolid in certain Enterococcus and Klebsiella isolates. Gram-positive cocci such as Staphylococcus aureus and Streptococcus species displayed increasing resistance to beta-lactams and macrolides, raising concerns about the future effectiveness of standard treatment options. Empirical antibiotic use was dominated by cephalosporins (82.7%) and imidazoles, while post-culture modifications favoured aminoglycosides and carbapenems, highlighting the role of culture sensitivity in guiding therapy. Comorbidities such as diabetes mellitus and anemia were common, increasing vulnerability to infections and complicating treatment. The study emphasizes the critical need for ongoing antimicrobial resistance surveillance and stricter antibiotic stewardship programs to curb the spread of emerging resistance. Integrating microbiological data into clinical decision-making proved essential for optimizing therapy and improving patient outcomes in the face of evolving resistance challenges.