Prescription trends and antibiotic utilization in pneumonia: an observational study at a tertiary teaching hospital

Pneumonia is a significant cause of morbidity and mortality, particularly among 5-year-olds, the elderly population, and those with comorbid conditions. As antibiotics are the most commonly used drugs, they need to be selected rationally to improve the therapeutic outcomes as well as to limit the emergence of antimicrobial resistance (AMR). This prospective observational study was carried out at Vivekananda Hospital, Hubballi, Karnataka, India, from October 2024 to March 2025. The data, such as demographics, laboratory values, patterns of prescription, and utilization trends from 200 study subjects, were collected, analyzed, and statistically tested using descriptive analysis. The World Health Organization core drug prescribing indicators revealed an average of 9775 drugs per prescription, of which antibiotics constitute 28.51%, with all prescriptions containing at least one antibiotic. Also, there is a high prevalence of polypharmacy, with the majority of prescriptions containing two or more antibiotics. The most commonly prescribed antibiotic was azithromycin, followed by ceftriaxone and piperacillin + tazobactam and the highest defined daily dose (DDD)/1000/days was observed in azithromycin (9.85), indicating potential overuse, whereas linezolid and cefixime had a prescriber daily dose value equal to DDD. The study emphasizes the need for improvement in generic prescribing, including the use of culture sensitivity tests for selection of appropriate antibiotics and implementation of an Antimicrobial Stewardship Program to optimize the antibiotic use and minimize the development of AMR.