A point prevalence surveillance study from pediatric and neonatal specialty hospitals in India

Point prevalence surveys (PPS) have been used to document antimicrobial use in healthcare organizations. Antimi- crobial resistance is a global concern, more so for developing countries like India, where the burden of antimicrobial resistance and infectious diseases are very high. A web based PPS developed by University of Antwerp, Belgium for the Antibiotic Re- sistance and Prescribing in European Children (ARPEC) project was used to enter data from pediatric and neonatal wards and intensive care units (ICU) from 8 centers across India. All patients who were receiving systemic antibacterial treatments on the day of the survey inclusive of antibacterial prophylaxis for surgery were included. 195 patients were surveyed across India: 105 (54%) medical and 90 (46%) surgical. 192 (98%) patients received multiple antimicrobials out of which 187 (95%) were given parenterally. Empirical antimicrobials were prescribed in 138 (71%) patients and targeted therapy in 57 (29%). The commonest infections for which antimicrobials were prescribed were healthcare associated infections 180 (41.76%) followed by surgical prophylaxis 90 (21%) and community acquired infections 84 (18%). Antimicrobials usage was maximal in ICUs. More than a single dose (5.6%) for more than a day (86.7%) was used for surgical prophylaxis. The Web based PPS suggests widespread antibiotic usage among pediatric and neonatal patients in selected tertiary Indian hospitals and underscores the need for antibiotic stewardship in order to promote rational and evidence based practice to limit the emergence of antibiotic resistant microbes.