A prospective study of antimicrobial utilization in post-operative care unit of a teaching hospital in South India


  • Mohammed Naseeruddin Nadeem Department of Pharmacology, Deccan College of Medical Sciences, Hyderabad, Telangana, India
  • Maliha Maqdoom Department of Physiology, Ayaan Institute of Medical Sciences, Hyderabad, Telangana, India




Antimicrobial agents, Surgical site infection, Prophylaxis, Drug utilization


Background: Surgical site infections, a common cause of morbidity and mortality in hospitalized patients can be prevented using an antimicrobial agent (AMA) as prophylaxis. Inappropriate use of AMA leads to antimicrobial resistance.

Methods: A prospective study was conducted on 208 patients in Owaisi Hospital and Research Centre (OHRC) for a period of 6 months on post-surgical patients admitted in the postoperative care unit. Included in the study were post-operative patients aged 18 years and above, who were willing to participate in the study. Data related to demography of the patients and the AMAs used in these patients was collected and analysed.

Results: Majority of the patients belonged to the age group 50 to 59 years (32%) followed by 40 to 49 age group (23%). Male patients (54%) were more than females. Common route of administration was intravenous (89%) and the most common dosing frequency was thrice a day (54%). Most AMAs were used in combinations. Metronidazole (62%) was the most commonly prescribed AMA, followed by ceftriaxone (55%).

Conclusions: Cephalosporins were the preferred antimicrobials for surgical prophylaxis of aerobic infections prescribed in 74% of cases, while metronidazole was used as the primary antimicrobial agent to prevent anaerobic infections. AMA utilization needs to be continuously evaluated in post-operative units of the surgery departments in order to promote rational prescribing to decrease morbidity, cost of therapy and to contain the problem of developing AMA resistance in the region.


Perencevich EN, Sands KE, Cosgrove SE, Guadagnoli E, Meara E, Platt R. Health and Economic Impact of Surgical Site Infections Diagnosed after Hospital Discharge. Emerg Infect Dis. 2003;9(2):196-203.

Bratzler DW, Houck PM. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis. 2004; 38:1706-15.

Van Boeckel TP, Gandra S, Ashok A, Caudron Q, Grenfell BT, Levin SA, Laxminarayan R. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis. 2014;14(8):742-50.

Klein EY, Van Boeckel TP, Martinez EM, Pant S, Gandra S, Levin S, Goossens H and Laxminarayan R. Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. PNAS. 2018;115(15):E3463-E3470.

World health organization. Antibiotic resistance. World health organization India; 2018. Available at: https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance. Accessed on 3 January 2020.

Carlet J. Epidemiology and control of antibiotic resistance in the intensive care unit. Curr Opin Inf Dis. 2004;17:309-16.

Georgeet SS, Varghese SR, Samuel CJ. Evaluation of antibiotic prescribing patterns among medical practitioners in North India. Ind J Bas App Med Res. 2013;8(2):952-7.

Thomas B, Matthew L, Jose J, Rathinavelu M, Shanmugam S, Kumar K. Assessment of antibiotic sensitivity pattern of microorganisms and their costeffectiveness at a private corporate hospital in south India. Asian J Pharm Clin Res. 2014;7:155-9.

Laporte JR, Porta M, Capella D. Drug utilization studies: a tool for determining the effectiveness of drug use. Br J Clin Pharmacol. 1983;16(3):301-4.

Bergman U, Popa C, Tomson Y, Wettermark B, Einarson TR, Aberg H, et al. Drug utilization 90%– a simple method for assessing the quality of drug prescribing. Eur J Clin Pharmacol. 1998;54(2):113-8.

Khade A, Bashir MSM, Sheethal A. Prescription pattern in the department of surgery in a tribal district hospital of Andhra Pradesh, India. Ann Med Health Sci Res. 2013;3(3);438-41.

Sharma P, Goel D. Utilization assessment of antimicrobial prophylaxis in surgical patients at tertiary care teaching hospital. Saudi J Health Sci. 2018;7:23-7.

Alemkere G. Antibiotic usage in surgical prophylaxis: A prospective observational study in the surgical ward of Nekemte referral hospital. PLoS ONE. 2018;13(9):e0203523.

Kulkarni RA, Kochhar PH, Dargude VA, Rajadhyakshya SS, Thatte UM. Patterns of antimicrobial use by surgeons in India. Indian J Surg. 2005;67:308-15.

Vadajiya S, Naik V, Mevada A. A study of antimicrobial drug utilisation pattern and appropriateness in the surgical units of the civil hospital, Ahmedabad. Int J Pure Appl Biosci. 2014;2:77-82.

Venkateshwar. Drug utilization study of antibiotics in surgical ward of a tertiary care hospital. Int J Chem Pharm Sci. 2015;6(1).

Khan AK, Mirshad PV, Rashed MR, Banu G. A study on the usage pattern of antimicrobial agents for the prevention of surgical site infections in a tertiary care teaching hospital. J Clin Diagn Res. 2013;7(4):671-4.




How to Cite

Nadeem, M. N., & Maqdoom, M. (2020). A prospective study of antimicrobial utilization in post-operative care unit of a teaching hospital in South India. International Journal of Basic & Clinical Pharmacology, 9(2), 310–314. https://doi.org/10.18203/2319-2003.ijbcp20200182



Original Research Articles