AUDIT ON APPROPRIATE PRESCRIBING OF ANTIBIOTICS (ANTIMICROBIAL STEWARDSHIP)

Abstract

Background: Antimicrobial resistance is a growing global concern, often driven by inappropriate antibiotic prescribing. This audit aimed to assess compliance with antimicrobial stewardship (AMS) practices in tertiary care hospitals of Rawalpindi.

Methodology: A retrospective, questionnaire-based review was conducted across three tertiary care hospitals—Holy Family Hospital, Benazir Bhutto Hospital, and DHQ Hospital. A total of 100 inpatient medical records from medical, surgical, and pediatric wards were randomly selected. Data were collected using a structured checklist evaluating key antibiotic prescribing indicators and analyzed using SPSS version 26.

Results: The indication for antibiotic use was documented in 88% of cases, and 74% of prescriptions adhered to national or local guidelines. Correct dose and frequency were observed in 81% of cases, while cultures were sent before antibiotic initiation in 61%. Review or de-escalation within 48–72 hours occurred in only 54% of cases. These findings highlight deficiencies in guideline adherence, culture testing, and timely therapy review.

Conclusion: Although documentation and dosing practices were satisfactory, significant gaps remain in guideline-based prescribing and stewardship compliance. Structured interventions, regular audits, and integration of antibiotic review alerts into electronic medical records are recommended to enhance rational antibiotic use.