PP 9 - Antimicrobial consumption survey at a tertiary care center in Sri Lanka

Jayanthan K¹, Francis VR², Devakanthan B ¹ , ¹Teaching Hospital, Batticaloa, ² Faculty of Health Care Sciences, Eastern University, Batticaloa

Abstract

Introduction

Antimicrobial resistance (AMR) is a major global health concern, driven largely by inappropriate and excessive antimicrobial use. Monitoring antimicrobial consumption in healthcare institutions is essential to promote rational use and support effective stewardship programs.

Objectives

This study aimed to assess the antimicrobial consumption at the Teaching Hospital, Batticaloa, using the World Health Organization (WHO) Defined Daily Dose (DDD) methodology and to propose a feasible plan for continuous monitoring of antimicrobial consumption in the hospital.

 Design, setting, and methods

A retrospective descriptive study was conducted based on the records from the hospital pharmacy. Data on all systemic antimicrobials issued from 1st January to 31st December 2024, to all medical, surgical gynaecology & obstetric and Oncology wards along with all subspeciality units including ENT, eye, orthopaedic, psychiatric, dermatology, tuberculosis and urology units and all ICUs were collected from the indoor pharmacy registry and entered onto a structured Google sheet. The data included all antimicrobials issued to the inward patients other than the paediatric units as standardized DDD methods cannot be applied to the paediatric population. Antimicrobial consumption was expressed as DDD per 100 occupied bed-days to allow for comparison across the wards and with similar studies conducted in other healthcare settings. Occupied bed days were calculated through midnight patient total of individual units.

Results

Total antimicrobial consumption (AMC) of the Teaching Hospital, Batticaloa was 88.8 DDDs per 100 bed days which is compatible with the reported AMC in the South Asian countries.  The predominant antimicrobials used belonged to the Access group accounting for 65% of the total use, which is in concordance with the WHO’s recommendation. Total usage of Reserve group antibiotics is around 1%. Surgical units revealed the highest AMC of 114.5 DDDs per 100 bed days. While ceftriaxone was the highest consumed antimicrobial in the hospital, surgical units consumed the highest amount of carbapenems in the hospital. Relatively high consumption of antimicrobials (85.8 DDDs/ 100 bed days) was noticed in the gynaecology and obstetrics units.

Conclusions

The hospital antimicrobial usage is within the acceptable limits while the stewardship committee should focus on AMC of selected units to ensure appropriate and effective use of antimicrobials. The study proposes a Google sheet-based data collection for continuous monitoring of AMC in the hospital as it will facilitate effective use of antimicrobials.