Antibiotic Utilization Pattern Based On WHO AWaRe Classification in General Medicine Department: A Prospective Observational Study

Abstract

Background: The Access, Watch, and Reserve (AWaRe) antibiotic classification was developed by the World Health Organisation (WHO) to enhance clinical outcomes and accessibility, minimize the likelihood of antimicrobial resistance, and conserve the efficacy of antibiotics used as a last resort.

Purpose: To study the antibiotic utilization pattern in a tertiary care hospital using WHO AWaRe classification.

Methods: A prospective observational study was conducted for 6 months among the in-patients of the tertiary care hospital. In-patients prescribed with antibiotics were enrolled in the study while the patients discharged within 24 hours of hospital admission were excluded.

Results: The study sample included 217 patients, among which 65% were males. 36.8% of the patients belonged to the 61-80 age group. It was observed that the Watch class of antibiotics (85%) were prescribed at a higher rate compared to the Access class (14.11%). Overall, the consumption of watch class antibiotics in terms of Days of therapy (DOT) was 875.31 DOT /1000 PD with cephalosporins being the most consumed class (619.07 DOT/1000 PD). Ceftriaxone was the most highly consumed antibiotic accounting for 566.35 DOT/1000 PD. There were no drug-drug interactions associated with ceftriaxone. The incidence of ADR was negligible, occurring in 0.9% of patients.

Conclusion: High prescription rate and usage of Watch group antibiotics, particularly cephalosporins, exceeding the WHO- recommended threshold was observed emphasizing the need for antimicrobial stewardship programs.