Antibiotic Prescribing Patterns for Respiratory Tract Infections in Urban Indian Outpatient Settings: A Multicenter, Retrospective, Observational, EMR-Based Study Using WHO AWaRe Classification
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Abstract
Background
Antimicrobial resistance (AMR) is an escalating global threat, particularly in low-and middle-income countries such as India, where high infection rates and widespread antibiotic misuse prevail. Despite the growing adoption of electronic medical record (EMR) systems, their potential for AMR surveillance remains underutilized.
Methods
In this multicenter, retrospective observational study, we analyzed anonymized EMR data from 183,608 outpatient prescriptions for respiratory tract infections (RTIs) in seven major metropolitan cities in India, collected between January 2021 and December 2023.
Results
Among these prescriptions, antibiotics were used in 59,779 (32%) cases, with a significant majority (85%) classified under the WHO AWaRe “Watch” category. Azithromycin (28.09%), cefpodoxime proxetil (19.07%), and cefixime (13.61%) were the most frequently prescribed antibiotics, while acute upper respiratory tract infections (URTIs) accounted for 40.6% of diagnoses associated with antibiotic use.
Conclusion
These findings underscore the urgent need for improved antibiotic stewardship through rigorous adherence to WHO AWaRe guidelines to curb the overuse of broad-spectrum antibiotics and mitigate AMR. Comprehensive antibiotic policies, regionally tailored strategies, and enhanced EMR-based surveillance are critical to fostering rational antibiotic use and reducing AMR rates in India.
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References
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