Evaluation of Antibiotic Prescription Pattern in In-Patients with Urinary Tract Infection in a Tertiary Care Centre

Abstract

Background: Urinary tract infections (UTIs) are among the most common infections in hospitalized patients. The inappropriate use of antibiotics for UTIs contributes significantly to the global burden of antimicrobial resistance (AMR). Understanding local antibiotic prescription patterns is essential to promote rational antibiotic use and formulate effective antimicrobial stewardship programs (ASP).

Objectives: This study aims to evaluate the pattern of antibiotic prescriptions in in-patients diagnosed with UTIs at a tertiary care center and assess the conformity of prescriptions with established treatment guidelines.

Methods: A retrospective observational study was conducted over a 12-month period (January 2023 – December 2023) at the Department of Medicine, [Hospital Name], [City, Country]. Data were collected from medical records of adult in-patients diagnosed with UTI. Variables analyzed included patient demographics, comorbidities, microbiological findings, antibiotics prescribed, route and duration of administration, and adherence to guidelines from the Indian Council of Medical Research (ICMR) and Infectious Diseases Society of America (IDSA).

Results: A total of 324 patients were included. The mean age was 52.7 ± 16.4 years, with 62.3% being female. Escherichia coli (E. coli) was the most common pathogen (58.3%), followed by Klebsiella pneumoniae (16.7%) and Enterococcus spp. (10.2%). Empirical antibiotic therapy was initiated in 88.6% of cases. The most frequently used antibiotics were ceftriaxone (34.2%), piperacillin-tazobactam (22.8%), and meropenem (15.1%). Culture sensitivity reports were available in 71.6% of patients, with antibiotic modification following sensitivity testing in only 38.5%. Overall, only 43.2% of prescriptions adhered to recommended guidelines.

Conclusion: The study reveals a high rate of empirical and broad-spectrum antibiotic use for UTI management, with suboptimal adherence to standard treatment guidelines. Enhancing diagnostic stewardship, regular audit of prescriptions, and strengthening of antimicrobial stewardship practices are recommended to optimize antibiotic use and mitigate resistance.

Keywords: Urinary tract infection, antibiotic prescribing pattern, antimicrobial resistance, in-patients, tertiary care hospital, stewardship