Fifty six percent of in-patients at JDWNRH were on antimicrobials, according to a first point prevalence survey conducted on the use of antimicrobials in the hospital in the country.
More than 130 out of 233 in patients were given antibiotics to treat certain bacterial infections according to the study done by a group of doctors. It showed a lower percentage of antimicrobial use compared to those in Vietnam, 67 percent and Egypt, 59 percent.
The study recommended more detailed assessments to identify areas of improvement in antimicrobial prescribing practices including the high use of third generation cephalosporins and ciprofloxacin.
These drugs are one of the widely prescribed antibiotics for bacterial infections in the country.
Effective antimicrobial stewardship, improved infection control strategies to reduce healthcare-related infections, enhanced microbiological surveillance and better diagnostic tools were found essential for effective response to antimicrobial resistance.
“Hospital-Acquired Infections (HAI) were recognised as a significant issue at JDWNRH,” the study found. The study also highlighted increasing travel for medical treatment outside Bhutan as a concern in triggering multi-resistant microorganisms and non-prescription antimicrobials of varying quality.
As commonly used antibiotics are no longer effective, doctors have to use stronger antibiotics resulting in delay in the right treatment, related complications, and deaths.
The world antibiotic awareness week observed in Thimphu last week highlighted the threat of increasing antimicrobial resistance (AMR) globally and educated those involved in the awareness programme on the usage of antibiotics.
Pharmacologist at JDWNRH Dr Pem Chuki said globally about 20 to 50 percent of antibiotic prescriptions were either unnecessary or inappropriate; wrong antibiotics were chosen to treat an infection, continued when no longer necessary, given a wrong dose and prescribed when not needed.
“Misuse or inappropriate use of antibiotics drives resistance. Increasing the use of antibiotics in a healthcare setting increases the prevalence of resistant bacteria in hospitals,” she said.
Head of pharmacy department, Thupten Tshering said antibiotics use was the most important factor driving AMR. “Overuse or misuse of antibiotics can increase selective pressure, which is an important determinant of the emergence of AMR. Measurement of antibiotic consumption enhances understanding of the epidemiology of AMR and to implement appropriate policies.”
His quantitative study on consumption pattern of antimicrobials in JDWNRH, which showed high use of cephalosporins was a concern. Other issues concerning the hospital were increase in carbapenems use significant despite the existing control mechanism and also highlighted the rise in the oral use of antibiotics use among others.
He said information on antibiotic consumption was useful in influencing the antibiotic prescribing behaviour and reminded the national data on antibiotic use as the need of the day.