OBJECTIVES : The benefits of antimicrobial stewardship have been well described and implemented in the inpatient setting. Because of emergence of drug resistance in community, it is the need of hour to monitor and review outpatient prescribing patterns also. Objectives were to explore and compare the pattern of SSTIs in Out-patients and In-patients. Additionally, to determine compliance of antibiotic use in SSTIs management as per National Centre of Disease Control (NCDC) of India.

METHODS : This prospective observational study included 90 and 136 patients diagnosed with SSTI from In-patients and Out-patients department whose culture investigation were done after the hospital visit. A predefined standard data collection form was used to archive relevant information. With the coordination of hospital Infectious Disease Department, all cases were analyzed meticulously after initiating empirical therapy till discharge. Appropriate statistical method was used.

RESULTS : The proportion of males (67.7%) were approximately double than females (32.3%). The common diagnosis were diabetic foot (20.35%), cellulitis (10.61%), and abscess (14.60%), surgical site infection (6.19%). Total 75.66% of prescription complied antibiotic policy in which it was seen 23.5% of inpatient and 47.6% of out-patients already had previous culture report. At the receipt of new culture report, only 36.7% prescriptions were changed according to the recent culture report. Total 13.71% were affected with methicillin resistant staphylococcus aureus (MRSA) and 7.52% affected with methicillin susceptible staphylococcus aureus (MSSA). The most common antibiotics prescribed for MRSA were piperacillin+tazobactum (15.7%), linezolid (15.7%), gentamicin, metronidazole, clindamycin (10.5% each).

CONCLUSIONS : This study revealed klebsiella and escherichia coli were predominant organism than MRSA in SSTIs. Diabetic and male patients are more vulnerable group for SSTIs.