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Impact of antimicrobial stewardship program on prescribing pattern of cephalosporins in the department of surgery

Urvi Patel, Anuradha Sujai Joshi, Jaishree Ganjiwale, Barna Ganguly.


Background: Cephalosporins are one of the widely prescribed antibiotics in clinical settings. Despite several years of its use, little is known about their prescribing pattern, especially in reference to antimicrobial stewardship program (ASP).

Aims and Objectives: Evaluation of cephalosporin prescribing pattern, prior to and after implementation of ASP.

Materials and Methods: This was an observational study on both prospective and retrospective data from surgery wards at a tertiary care teaching hospital. Data were collected from surgery case files and analyzed for demographic details, cephalosporin prescribing pattern, and its appropriateness in relation to ASP.

Results: Data were selected from a total of 300 surgery case files (n = 150 each of year 2012 and 2014). Overall, there were 68% of male and 32% of female patients. Cephalosporins were prescribed, generation wise, i.e., the 1st generation in 34.7%, the 2nd in 1.3%, the 3rd in 63.3%, and the 4th in 0.7%, in 2012, while in 2014, they were prescribed as follows: 55.3% (1st), 0.7% (2nd), 44% (3rd), and 0.0% (4th). In 2012, various types of treatments were advocated consisting of cephalosporins, i.e., 73.3% (prophylactic), 26.7% (empirical), while none were rendered definitive treatment. In 2014, 91.3% of patients were treated prophylactically, 6.7% were treated empirically, and 2.0% were on definitive therapy. About 77.3% of patients were switched over from parental to oral in 2012 while 78% in 2014. The data revealed significant impact of ASP (P < 0.05), in terms of appropriate prescribing of cephalosporinÂ’s, i.e., 13.3% in 2014 and 6.7% in 2012, respectively.

Conclusion: Successful implementation of ASP can improve antibiotic prescribing in clinical practice.

Key words: Cephalosporins; Antimicrobial Stewardship Program; Surgery

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