Background: The inappropriate use of antibiotics in hospitals increases resistance, morbidity, and mortality. Little is\ncurrently known about appropriate antibiotic use among hospitals in Lahore, the capital city of Pakistan.\nMethods: Longitudinal surveillance was conducted over a period of 2 months among hospitals in Lahore, Pakistan.\nAntibiotic treatment was considered inappropriate on the basis of a wrong dosage regimen, wrong indication, or\nboth based on the British National Formulary.\nResults: A total of 2022 antibiotics were given to 1185 patients. Out of the total prescribed, approximately twothirds\nof the study population (70.3%) had at least one inappropriate antimicrobial. Overall, 27.2% of patients had\nrespiratory tract infections, and out of these, 62.8% were considered as having inappropriate therapy.\nCephalosporins were extensively prescribed among patients, and in many cases, this was inappropriate (67.2%).\nPenicillins were given to 283 patients, out of which 201 (71.0%) were prescribed for either the wrong indication or\ndosage or both. Significant variations were also observed regarding inappropriate prescribing for several\nantimicrobials including the carbapenems (70.9%), aminoglycosides (35.8%), fluoroquinolones (64.2%), macrolides\n(74.6%) and other antibacterials (73.1%).\nConclusion: Educational interventions, institutional guidelines, and antimicrobial stewardship programs need to be\ndeveloped to enhance future appropriate antimicrobial use in hospitals in Pakistan. Policies by healthcare and\nGovernment officials are also needed to minimize inappropriate antibiotic use.
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