An evaluation of antibiotic prescription pattern and drug rationality analysis among outpatients at public health setting, India
Open accessAbstract
BACKGROUND: Antibiotic resistance (AMR) is a significant worldwide health problem, with inappropriate antibiotic prescription being a major contributing factor. Prudent antibiotic use is essential for enhancing health outcomes and reducing AMR. This study assesses antibiotic prescribing practices and their logic in a public community health facility catering to 12,900 urban and rural populations in North India. METHODS: Cross-sectional research was performed from August 2021 to August 2022, examining 1219 outpatient antibiotic prescriptions. The data encompassed medication kind, dose, duration, adherence to therapeutic criteria, and rationale evaluated by ID specialists and clinical pharmacologists. The evaluation was conducted in accordance with standard procedures, including those from NCDC and PGIMER. Demographics, antibiotic classifications, WHO AWaRe categories, diagnoses, and compliance with the essential drug list (EDL) were evaluated. RESULTS: The results indicated that 45.9 % of prescriptions were for males and 54 % for females, predominantly involving individuals aged 20-40 years. Amoxicillin + clavulanic acid (27.2 %) was the most often given antibiotic, followed by metronidazole (13.4 %) and azithromycin (10.3 %). The WHO AWaRe categorization revealed that 49.7 % of antibiotics were categorized as "Access," 27.3 % as "Watch," and none as "Reserve." An examination of rationality indicated that 57 % of urinary tract infection prescriptions were justified, but just 29 % of respiratory tract infection prescriptions were deemed logical. Diarrhea and respiratory tract infections were recognized as primary targets for minimizing superfluous antibiotic consumption. CONCLUSION: The research underscores the necessity for enhanced antibiotic prescription protocols in outpatient environments. Specialized education for healthcare professionals, improved prescription oversight, and compliance with evidence-based protocols are essential for fostering judicious antibiotic utilization and addressing AMR.
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In India, easy over-the-counter access, empirical prescribing habits, and variable diagnostic support have led to amoxicillin and clavulanic acid being one of the most frequently dispensed antibiotics in outpatient and inpatient care.
“In the Indian context, the situation is particularly complex. The combination of easy over-the-counter access, empirical prescribing habits, and variable diagnostic support has led to amoxicillin and clavulanic acid being one of the most frequently dispensed antibiotics in outpatient and inpatient care [7].”
From Clinical Outcomes and Real-World Effectiveness of Amoxicillin-Clavulanic Acid Across Indian Healthcare Settings: A Retrospective Multicenter Study (2026) · cites this paper as [7]
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Self-citationAntibiotic prescribing and resistance beyond hospital surveillance networks in IndiaPreprint
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Self-citation
- Authors
- Modgil, V., Shafiq, N., Gondara, A., Surial, R., Singh, H., Karol, V., Kaur, M., Lambert, H., & Taneja, N.
- Affiliations
- Post Graduate Institute of Medical Education and Research (IN)
- University of Bristol (GB)
- Corresponding author
- Taneja, Neelam
- Venue
- Indian Journal of Medical Microbiology
- Publisher
- Elsevier BV
- Published
- 2025-05
- Volume
- 55
- Pages
- 100829
- ISSN
- 0255-0857 (ISSN-L)
- OpenAlex
- W4408952792
- Cited by
- 5
- References
- 26
- Citations by year
- 2026: 4 · 2025: 1
- FWCI
- 3.31
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Indian Journal of Medical Microbiology (publishedVersion)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (acceptedVersion, cc-by)
- Explore Bristol Research (submittedVersion, cc-by)
- Funders
- DBT (BT/IN/Indo-UK/AMR-Env/05/NT/2020-21)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
- Keywords
- antibiotic prescribing, antibiotic resistance, rational drug use, outpatient prescriptions, AWaRe classification, essential medicines list, urinary tract infection, respiratory infections, diarrhea, amoxicillin-clavulanic acid, metronidazole, azithromycin, rational antibiotic use, public health facility
- MeSH terms
- Adolescent, Adult, Aged, Anti-Bacterial Agents, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, India, Infant, Male, Middle Aged, Outpatients, Practice Patterns, Physicians', Drug Prescriptions, Public Health, Young Adult
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