Prescribing Antibiotics Among Post-operative Patients in Obstetrics and Gynecology Department of Two Tertiary Care Hospitals of Bangladesh

Background:
Antibiotics are important in obstetrics and gynecology for preventing
and treating infections, inappropriate use contributes to antimicrobial
resistance.
Objective:
To evaluate the prescribing pattern of the antibiotics in postoperative
patients admitted in gynaecology and obstetrics at Dhaka Medical
College Hospital (DMCH) and Rangpur Medical College Hospital
(RpMCH).
Methods:
This cross-sectional observational study was carried out among the
post-operative patients admitted in Obstetrics and Gynecology
Departments of Dhaka Medical College Hospital & Rangpur Medical
College Hospital from July 2017 to June, 2018. A total of 500 sample;
250 from Dhaka center (DMCH) and 250 from Rangpur center
(RpMCH), was enrolled through purposive sampling.
Sociodemographic data of the participants, diagnosis, number of
prescriptions containing antibiotic, numberof antibiotic per
prescription, name of drugs in generic or in trade name were recorded.
Results:
Among 500 subjects, 250 were from gynaecological cases and 250 from
obstetrical cases. The average age was29.88±11.29 years (range: 18-70
years), with most participants (56.6%) from rural areas. Among 3978
prescribed drugs, average number of drugs per prescription was
7.91±1.49 with 28.43 % being antibiotics. 34.23% drugs were
prescribed by generic names and hospital supplied drugs were 39.64%.
After surgery, 72.6% of patients received two injectable antibiotics, with
higher rates in Dhaka (77.2%) compared to Rangpur (68%). The average
number of injectable antibiotics was similar in both centers (2.17±0.48),
but oral antibiotics were more common in Dhaka (2.22±0.48 vs
2.03±0.8). Most used injectable antibiotic was ceftriaxone (Dhaka
center vs Rangpur center, 88.8%, vs 82.4%) and metronidazole (Dhaka
center vs Rangpur center 95.2% vs 55.6%), while cefixime(Dhaka
center vs Rangpur center 64% vs 44.4%) and metronidazole (Dhaka
center vs Rangpur center 82.8% vs 22.8%) were the most common oral
antibiotics at discharge.
Conclusion:
Ceftriaxone and Metronidazole were frequently administered to
postoperative patients. This indicates a trend of polypharmacy that
could be reduced by selecting broad-spectrum antibiotics after culture
and sensitivity.