OBJECTIVES: To assess the utilization pattern and evaluate the appropriateness of antibiotic use in the surgery department of a tertiary care hospital.

METHODS: A prospective interventional study was conducted for a period of 9 months in the General Surgery wards of a tertiary care hospital. All those patients who were admitted to the general surgery wards were reviewed on a daily basis and those who met the study criteria were enrolled into the study and were followed till discharge. All the required information pertaining to the patient’s medical history was recorded. Appropriateness of the prescribed antibiotics was assessed based on the available antibiotic susceptibility reports and evidence-based medicine. The predictors associated with inappropriateness of antibiotic use was assessed by using bivariate logistic regression analysis.

RESULTS: Of the 614 patients, majority,64.49% were males. Most of the patients belonged to the age group of 40-59 years (35.99%). Most of the patients were diagnosed with the digestive system and related disorders (51.21%). A total of 1085 antibiotics were prescribed and beta-lactam class (70.6%) was the most frequently prescribed class of antibiotics. Cefuroxime+ sulbactam (44%) with total DDD of 2128.4 was the most frequently prescribed antibiotic. In majority (64%) of the cases, antibiotics were prescribed inappropriately. Among the inappropriate cases, the excessive regimen of antibiotics (35.29%) was the highest. There was a strong association between the inappropriateness of antibiotic use and presence of two and three comorbid conditions, receiving two antibiotics and length of stay of 6-10 and 16-20 days (P < 0.05).

CONCLUSIONS: The incidence of antibiotic use in the general surgery ward was found to be 48.5%. Although antibiotics form an inevitable part of surgical care, the cautious and rational use of antibiotics is warranted.