ANTIMALARIAL STEWARDSHIP PRACTICES FOR ACUTE UNDIFFERENTIATED FEBRILE ILLNESS PATIENTS IN TERTIARY CARE HOSPITALS: A PROSPECTIVE OBSERVATIONAL STUDY

ANTIMALARIAL STEWARDSHIP PRACTICES FOR ACUTE UNDIFFERENTIATED FEBRILE ILLNESS PATIENTS IN TERTIARY CARE HOSPITALS: A PROSPECTIVE OBSERVATIONAL STUDY

Dr. C.P YOGAVIGNESHWARAN - MDCCC-140

Background

Irrational antimicrobial prescription practices are widespread throughout the globe, amidst various antimicrobial stewardship programs being developed on a great run. Malaria is a parasitic fever, which appears as a leading cause of mortality in which there is not yet many advancing stewardship programs, for the antimalarial agents such as quinine, quinolones, artemisinin and the other agents such as pyrimethamine, antifolates etc. Acute undifferentiated febrile illness remains the most common presenting symptom for various tropical and other infections, for which antimicrobials are prescribed empirically. The aim of our study is to compare the prevalence of inappropriate use of antimalarial and antibiotic practices.

Methods

We conducted a prospective analysis during the period of April 2023 – May 2023 at multiple tertiary care hospitals, in patients having acute undifferentiated fever. Demographic data, diagnosis, patient complaints laboratory parameters, antimalarial and antibiotic prescribing practices, were recorded using an audit tool. Descriptive statistics were used to analyze and tabulated. Hence, antimalarial and antibiotic prescription practices were analyzed and compared.

Results

A total of 2997 patients were recruited from various departments in multiple hospitals, the obtained results are summarized in table-1 below.

Conclusion

Nearly 52% of audited hospitalized patients and patients who visited out-patient department for self-limiting febrile illness received antibiotics inappropriately. Out of which cephalosporins (cefixime, cefotaxime), Macrolides (Azithromycin), Tetracycline (Doxycycline) were commonly prescribed. But, none of the patients received antimalarials as an empirical therapy for acute undifferentiated febrile illness. This shows that antimalarial stewardship practices are promptly followed in all the tertiary care hospitals. In the future, antimicrobial stewardship practices in the developing world should focus on tropical infections apart from bacterial and fungal infections.