Antibiotic Use Evaluation Using WHO Methodology in a Private Hospital, Yangon, Myanmar

Abstract

Reliable data on antibiotic consumption is a prerequisite for understanding the situation of antibiotic use. In this study, we aimed to evaluate antibiotic use, antibiotic consumption patterns, and antibiotic prescribing patterns in the outpatient and inpatient departments (OPD and IPD, respectively) of a private hospital in Yangon, Myanmar. This retrospective cross-sectional study was conducted in 2017. Antibiotic use data from January-December 2017 was retrieved from the hospital database and medical records, which included 9,134 and 4,140 outpatient and inpatient, respectively, antibiotic-containing prescriptions. The World Health Organization (WHO) unit measurement (defined daily dose, DDD) and prescribing indicators were used for evaluating antibiotic consumption and prescribing patterns, respectively. Antibiotics were administered in 21% of outpatient visits and 70% of inpatient admissions. Regarding antibiotic consumption, 44,959 and 31,861 DDDs were consumed in OPD and IPD, respectively. Broad-spectrum antibiotics (beta-lactam penicillins, fluoroquinolones, and third-generation cephalosporins) were mostly prescribed in both OPDs and IPDs. Moreover, antibiotics were mostly prescribed for respiratory tract infections and acute viral infections in the OPD. Almost all prescribing indicators were acceptable in accordance with the WHO standard values, except the rate of generic prescription, which was lower than the recommended rate. The findings suggested that the government sector and hospitals should develop policies and regulations to evaluate antibiotic use. Prescription practice guidelines for antibiotics are needed to ensure appropriate medicine use. Furthermore, important findings of this study could contribute to the design of various interventions to promote rational use of antibiotics.