Open Access Research article

Antibiotic prescribing in two private sector hospitals; one teaching and one non-teaching: A cross-sectional study in Ujjain, India

Megha Sharma12, Bo Eriksson3, Gaetano Marrone2, Suryaprakash Dhaneria1 and Cecilia Stålsby Lundborg2*

Author Affiliations

1 Department of Pharmacology, R.D. Gardi Medical College, Ujjain, MP, 456101, India

2 Division of Global Health, IHCAR, Department of Public Health Sciences, Karolinska Institutet, Nobels väg 9, Stockholm, Sweden

3 Nordic School of Public Health, Box 121 33, SE 402 42, Göteborg, Sweden

For all author emails, please log on.

BMC Infectious Diseases 2012, 12:155  doi:10.1186/1471-2334-12-155

Published: 12 July 2012



The worldwide increase in antibiotic resistant bacteria is of great concern. One of the main causes is antibiotic use which is likely to be high but is poorly described in India. The aim was to analyze and compare antibiotic prescribing for inpatients, in two private sector tertiary care hospitals; one Teaching and one Non-teaching, in Ujjain, India.


A cross-sectional study with manual data collection was carried out in 2008. Antibiotic prescribing was recorded for all inpatients throughout their hospital stay. Demographic profile of inpatients and prescribed antibiotics were compared. WHO Anatomical Therapeutic Chemical (ATC) classifications for antibiotics was used and Defined Daily Doses (DDD) were calculated per patient day.


A total of 8385 inpatients were admitted during the study period. In the Teaching hospital (TH) 82% of 3004 and in the Non-teaching hospital (NTH) 79% of 5381 patients were prescribed antibiotics. The most commonly prescribed antibiotic groups were; fluoroquinolones and aminoglycosides in the TH and, 3rd generation cephalosporins and combination of antibiotics in the NTH. Of the prescriptions, 51% in the TH and 87% in the NTH (p<0.001) were for parenteral route administration. Prescribing by trade name was higher in the NTH (96%) compared with the TH (63%, p<0.001).


The results from both hospitals show extensive antibiotic prescribing. High use of combinations of antibiotics in the NTH might indicate pressure from pharmaceutical companies. There is a need to formulate and implement; based on local prescribing and resistance data; contextually appropriate antibiotic prescribing guidelines and a local antibiotic stewardship program.