Assessment of Rational Antibiotic use in General Medicine Wards: a Prospective Observational Study

Abstract

Background: Irrational use of antibiotics is a major contributor to antimicrobial resistance (AMR), increased healthcare
costs, and adverse drug reactions. Monitoring antibiotic prescribing patterns is essential for promoting rational drug use.
Objective: To assess the rational use of antibiotics in general medicine wards of a tertiary care hospital.
Methods: This prospective observational study was conducted over 12 months (February 2025 to January 2026) at
Bhagwan Mahavir Institute of Medical Sciences, Pawapuri. A total of 190 patients admitted to general medicine wards
and receiving antibiotics were included. Data regarding demographics, diagnosis, antibiotic prescriptions, and adherence
to standard guidelines were collected. Rationality was assessed using WHO prescribing indicators and standard treatment
guidelines. Statistical analysis was performed using SPSS version 25.
Results: Out of 190 patients, 61.6% received rational antibiotic therapy, while 38.4% prescriptions were irrational. The
most common irrationalities included inappropriate drug selection (18.4%), incorrect duration (11.6%), and improper
dosage (8.4%). Third-generation cephalosporins were the most commonly prescribed antibiotics (42.1%). Culture
sensitivity testing was performed in only 36.8% cases. A statistically significant association was found between culture
testing and rational prescribing (p < 0.05).
Conclusion: A substantial proportion of antibiotic use was irrational. Strengthening antimicrobial stewardship programs
and adherence to treatment guidelines are essential to improve rational antibiotic use.