Antibiotic misuse and overuse in hospitalized patients with nosocomial infections in North of Iran

Improper use of antibiotics increases the cost of treatment, incompetent therapy, longer hospitalization time, more visits to the doctors, and improper treatment of the patients, lack of infection control, and the development and spread of antibiotic resistance. The objective of this study was the evaluation of antibiotic misuse and overuse in hospitalized patients with nosocomial infections in BuAli Sina hospital, in the north of Iran. This retrospective cross-sectional study was performed by census methods on all nosocomial infections patients hospitalized in BuAli Sina's educational and therapeutic hospital. Data were collected from March 2016 to March 2018. All data were obtained from computerized archives and manual archives of the hospital. SPSS 16.0 was used for statistical analysis using Chi-square, Kolmogorov-Smirnov, and Mann-Whitney tests. Out of 517 patients studied, 221 (42.7%) of them were male. The average age of the patients was 45.64±34.01. The Most Common isolated bacteria from all patients were Escherichia coli (48.8%) and Staphylococcus epidermidis (22.9%). According to the antibiotic prescription in the present study, most patients (35.8%) took at least two antibiotics. The most antibiotics falsely prescribed by physicians in the present study were used for the treatment of the infections caused by E. coli (50.34%) and Klebsiella pneumoniae (20.97%). There seems to be a need to set up a team to prevent antibiotic misuse and microbial resistance and to pay attention to the antibiotics prescribed for infectious patients. These include training programs for physicians, consulting with infectious disease specialists, reducing empirical prescriptions by physicians, and spontaneous antibiotic use by patients.