Pattern of antibiotics usage in a community hospital of Malwa region of Punjab, India.

To assess the pattern of antibiotic utilisation and outcome of patients with bacteraemia in the hospital. All positive blood cultures (BC) over a 12-month period from January 2011 to December 2011 were retrospectively reviewed. Positive BC were recorded in 54 patients. 51.9% of the patients received antibiotics before or soon after obtaining the BC, and ceftriaxone was the most frequently-prescribed antibiotic (42.9%), either alone or in combination with other antibiotics. The bacteraemia was due to gram-negative rods in 84.9% and gram-positive cocci in 15.1% of cases. Most common gram-negative bacilli were E. coli, Klebsiella pneumoniae and Salmonella species while most common gram-positive cocci was Staphylococcus aureus. Antibiotics regimen was changed in 37% cases after BC results became available. Most frequent change was addition of meropenem in case of gram-negative bacilli (29.6%) and vancomycin in gram-positive cocci (12.5%).Ten (18.5%) patients developed serious sepsis or septic shock; 3 (30.0%) improved and 7(70.0%) had fatal outcome. Antibiotic selection needs tobe tailor made for each patient. However, most bacteraemia necessitating hospital admission are due to gram-negative bacilli and it should be considered in antibiotic selection prior to BC.