Misuse of Antibiotics in Al-Hussein Teaching Hospital in Karbala


background: Antibiotics (AB) are available and widely used all over the world. However, the overuse and misuse of antibiotics generates unnecessary costs, produces unwanted side effects, and causes the emergence of resistant bacteria that is a raising serious problem especially in developing countries.Objectives: To assess the use of antimicrobial drugs and rationality of its use.Methods: An analytic cross-sectional study was carried out in Al-Hussein Teaching Hospital in Holly Kerbala City in Iraq. A sample of 302 hospitalized patients was randomly selected from coronary care unit, medical wards, and surgical wards, clinical data were collected using specific questionnaire through direct interview with patients and from patient’s case sheets during the period from 5th December 2013 to 30th June 2014. Ethical approval was taken from Scientific Council of Family Medicine in Arab Board Committee Baghdad. Data were entered and analyzed using SPSS program version 16. A p value of less than 0.05 was considered statistically significant.Results: Antibiotics were prescribed in 81.5% of hospitalized patient. The collective rate of irrational use of antibiotics was 83.3%. Inappropriate antibiotic use was significantly higher in patients who had been hospitalized in surgical branches wards (91.8%) followed by general surgery wards (88.4%), while the lower antibiotic misuse was in coronary care unit ward (73.9%). ABs indication in Medical wards was 100% Empirical, while 75% of ABs indication in General surgery ward was prophylactic.Conclusion: The rate of irrational antimicrobial use was high in hospitalized patients, and more in surgical wards. The antibiotic selection was optional and not according to any guidelines or recommendations. The antibiotics prescription was mainly empirical in medical wards, while it was prophylactic in surgical wards. Further, the use of culture and sensitivity test was very limited. These attitudes are probably leading to more risky side effects and drug resistance. Strict guidelines and valid policies need to be adapted in each hospital to decrease the antibiotic misuse.