AN EVALUATION OF ANTIBIOTIC PRESCRIPTION PATTERN AND DRUG RATIONALITY ANALYSIS AMONG OUTPATIENTS AT PUBLIC HEALTH SETTING, INDIA

Antimicrobial resistance (AMR) poses a top global health threat, driven largely by
inappropriate antibiotic prescribing. The WHO's Global Action Plan emphasizes prudent
antibiotic use to curb AMR, yet up to 50% of prescriptions worldwide remain irrational,
especially in outpatient settings of developing countries like India. Factors such as
overprescription without diagnostics exacerbate the issue. Purpose of this study evaluated
antibiotic prescribing patterns and rationality in a public community health facility serving
12,900 urban-rural populations in North India, aiming to identify gaps and inform
stewardship interventions. A cross-sectional audit of 1,219 outpatient antibiotic prescriptions
occurred from August 2021 to August 2022. Experts (ID specialists, clinical
pharmacologists) assessed drug type, dose, duration, adherence to NCDC/PGIMER
guidelines, WHO AWaRe classification, diagnoses, and essential drug list compliance using
standard protocols. Prescriptions skewed female (54%) and aged 20-40 years. Amoxicillin
clavulanic acid (27.2%), metronidazole (13.4%), and azithromycin (10.3%) dominated.
AWaRe breakdown: 49.7% Access, 27.3% Watch, 0% Reserve. Diarrhea and respiratory
infections emerged as key areas for reducing overuse. Findings highlight suboptimal
prescribing, particularly for self-limiting infections, underscoring needs for prescriber
training, audit oversight, and evidence-based guidelines to boost Access antibiotic use toward
WHO targets and combat AMR.