Patterns of antibiotic use in Indian secondary care hospitals: Results from a multicenter point prevalence survey.

OBJECTIVES

To assess antibiotic prescribing patterns and quantify antibiotic use in secondary care hospitals in South India using a point prevalence survey, and to generate baseline data to support antimicrobial stewardship initiatives and national AMR surveillance efforts.

METHODS

A point prevalence survey (PPS) was conducted between April-September 2025 across 12 secondary care hospitals in India. All inpatients present at 8:00 am on the survey day were included. Data included patients' characteristics, antimicrobials received, and therapeutic indications.

RESULTS

Among the 359 patients surveyed, 196 (54.6%) received at least one antibiotic, with hospital-level prevalence ranging from 24% to 100%. Most antibiotics were administered parenterally (84.8%), and respiratory infections (20.9%) were the leading indication. Empirical therapy accounted for 53.1% of prescriptions. Broad-spectrum antibiotics, predominated. Culture sensitivity testing was documented in 28% of cases, reflecting limited microbiological support. AMS programs were largely absent. According to WHO AWaRe classification, 74.2% of prescriptions were from Watch group, and only 22.1% from Access.

CONCLUSION

Antibiotic use in secondary care hospitals shows high variability and suboptimal practices, underscoring the need for strengthened AMS, improved diagnostics, and better guideline adherence.