This document discusses a prospective study to evaluate the usage of antimicrobial agents in a tertiary care hospital in India. It notes that while medicines play an important role in healthcare, irrational drug use is common, especially in developing countries. Antimicrobial resistance has become a major problem in treating infectious diseases. Therefore, antimicrobial utilization studies are important to promote appropriate usage. The study aims to assess patterns of prophylactic and therapeutic antimicrobial use over two months by collecting data on prescriptions and patient records to evaluate rationality and analyze prescribing behaviors.

2.  Medicines play an important role in health care delivery and disease
prevention.
 The availability and affordability of good quality drugs along with their
rational use is needed for effective health care.
 However, irrational drug use is prevalent, especially in the developing
countries due to irrational prescribing, dispensing, and administration of
medications.
 Also, the World Health Organization (WHO) reports that more than half
of all medicines are prescribed [1], dispensed or sold inappropriately and
that half of all patients fail to take them correctly.
 Antimicrobials are one of the most common groups of drugs prescribed
in hospitals.
 The extraordinary therapeutic effects of antimicrobials, the problems of
registrant microorganisms, irrational prescribing, different untoward
toxic-effects and high cost involved – up to 40% of a hospital’s drug
expenditure–are compelling reasons for concern about optimising and
appropriate use of antimicrobials [3].

3.  As there is a rise in the antimicrobial resistance and a decline in the
development of new antibiotics.
 Antimicrobial Resistance (AMR) has become a major obstacle in the way
of the treatment of infectious diseases worldwide [4].
 Therefore, to fight against AMR, antibiotic utilisation studies are being
carried out.
 Instituting appropriate therapy is essential for a favorable outcome of the
patient and to decrease mortality and morbidity.
 Clinicians often face challenges in selecting, initiating and individualizing
appropriate drug therapy for patients admitted in the emergency
medicine ward[6].
 A prescription based survey (drug utilization study) is considered to be
one of the most effective methods to analyze the prescribing pattern of
drugs and prescribing behavior of physicians.[7,8]
 Monitoring the trends in drug utilization in tertiary care hospital can
provide insight into major health-care problems.
 Therefore, with the same perspective, this prospective study will be done
to evaluate the current usage of the anti-microbial agents in Tagore
Medical College And Hospital, Chennai

4. The aim of this study is to assess the pattern of
prophylactic as well as therapeutic use of
antimicrobials in a tertiary care hospital which is
important for the initiation of the prudent and
appropriate use of antimicrobials in tertiary care
hospital.
 To study antimicrobial compliance among OPD
Patients
 To create awareness of antimicrobial resistance
among public
 To understand the importance of antimicrobial
audit

5. Because of increasing concern and awareness
of antibiotic resistance problems worldwide and
frequent inappropriate use of antimicrobial agents
in hospitals, these drugs have often been the target
of attempts to evaluate and control their uses [2]. A
cross sectional study is conducted to evaluate the
appropriateness of use of antimicrobials in both
therapy and prophylaxis at a tertiary care hospital

6. This is a prospective study which will be done for a period of
two months. The prescriptions and the patient records are reviewed
and analysed. The rationality of the drug usage will also evaluated by
analysing the drug prescription.
Data collection
All data are to be collected by patient files and the electronic
patient files. The following patients’ variables are to be recorded: ward,
file number, date of admission, date of interview, age, sex, nationality,
weight, height, diagnosis, associated medical problems (co-
morbidities) and does the patient take antibiotic(s). In patients with
antibiotic prescriptions, we recorded all prescribed antibiotics,
including dose, frequency, route of administration, duration, and
whether the drugs are given in prophylactic or therapeutic purpose [2].
Furthermore, the results of laboratory and microbiological
investigations available at the time of the survey will be reviewed to
assess the appropriateness of diagnosis of infectious disease leading to
the prescription of antibiotic.

7. The demographic and clinical treatment data of patients will be collected in the following format:
Name:
Age/sex:
Gender: Female/Male
Address:
Marital status: Married/Unmarried
Father/Spouse name:
Employment status:
Inpatient/outpatient:
Prophylactic/Therapeutic:
Department:
Diagnosis of patients:
Drugs taken:
Penicillin Griseofulvin Cephalothin Polymyxin Bacitracin
Gentamicin Neomycin Tetracycline Vancomycin Erythromycin
Rifampin Ivermectin Streptomycin Chloramphenicol Macrolides
Ampicillin Metronidazole Azithromycin Amphotericin B Meropenem
Ceftriaxone Vancomycin Levofloxacin Co-trimoxazole Ciprofloxacin
Linezolid Amikacin Gentamicin Amoxicillin+Clavulanic acid
Others
Dose and route of AMAs:
Duration of treatment:
Other diseases:

8. Data will be entered and it will be tabulated
finally the data will be analysed from which
conclusion will be obtained