Assessment of Antibiotic Utilization Using Who’s AWaRe Framework in a South Indian Tertiary Care Hospital

Introduction: The issue of antimicrobial resistance presents a significant obstacle to global health, largely driven by the inappropriate use of antibiotics, especially in tertiary care settings. In response, the WHO has introduced the AWaRe framework to promote the rational use of antibiotics; however, further investigation is required to effectively implement this framework within Indian hospital settings. Aim: This research intends to assess the patterns of antibiotic prescriptions within a south-Indian tertiary care hospital, employing the WHO's AWaRe framework combined with a range of prescribing indicators. Methods: This observational, prospective study was carried out at a Tertiary Care Hospital in Kakinada from September 2024 to February 2025. Data was collected and analysed from 136 patient records receiving systemic antibiotics via EHR, and clinical outcomes were analysed using descriptive statistics and the Chi-Square test. Results: Our study showed a significant prevalence of Watch group antibiotics, accounting for 63.9% of prescriptions, in contrast to the mere 13.2% for Access group antibiotics. More common empirical prescribing raises concerns regarding the potential escalation of antibiotic resistance. It is crucial to recognise that the patterns of antibiotic prescribing have a significant influence on patient outcomes. Conclusion: The antibiotic prescribing practices in this study suggest a significant need for improvement, particularly in the use of Watch group antibiotics. This offers an opportunity to align better with WHO AWaRe guidelines. Targeted antimicrobial stewardship initiatives are crucial for promoting responsible antibiotic use and enhancing patient outcomes. Future research should evaluate the effectiveness of these interventions and their long-term impact.