International Journal of Drug Delivery Technology
Volume 16, Issue 6s, 2026

Restricted high-end antibiotics monitoring and policy adherence rate in a tertiary care hospital

Kalaivani Ramakrishnan1, Savithri Balaji2, Johan Pandian J3, Sujaritha Thangaraju4, Poonguzhali S5, C.P. Ganesh Babu6*

1Additional Professor, Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Madurai, Tamil Nadu, India

2Infection Control Nurse, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Deemed-to-be University, Puducherry, India

3Professor of Pharmacology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Deemed-to-be University, Puducherry, India

4Assistant Professor of Critical Care Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Deemed-to-be University, Puducherry, India

5Infection Control Nurse, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Deemed-to-be University, Puducherry, India

6Professor and Head, Department of General Surgery, All India Institute of Medical Sciences (AIIMS), Madurai, Tamil Nadu, India

Corresponding author*
Dr. C.P. Ganesh Babu
Professor and Head, Department of General Surgery, All India Institute of Medical Sciences, Madurai, Tamil Nadu, India

ABSTRACT

Background: AMR is an emerged silent global pandemic leading to significant mortality and morbidity with a great cause of concern to tackle. Improved access to antibiotics and surveillance of antibiotic consumption are the key component to prevent AMR. AMSP implements strategies to ensure the right drug, dosage, route, and duration of antimicrobial therapy and promotes infection prevention and control measures. Considering this, the current interventional study aims to portray the effect of restricted High-End Antibiotic (HEA) usage monitoring from January to December 2022 (pre intervention) and January 2023 to December 2024 (post intervention) from a tertiary care hospital.

Materials and Methods: Between pre and post intervention periods, the usage of HEA (meropenem, imipenem, ertapenem, doripenem, colistin, polymyxin B, tigecycline, fosfomycin, ceftazidime-avibactam+/- aztreonam, vancomycin, linezolid, teicoplanin, daptomycin, cefepime and ceftaroline) were monitored towards their trend, appropriateness, whether clinical samples were sent for culture/sensitivity testing before starting HEA, frequency of escalation and de-escalation followed.

Results: Patient with 45 to 70 years of age, urosepsis (25%) and sepsis/ shock (35%) were found to be high risk groups. MRP, CL, PB, TIG, FOS, CAZ-AVI+/-AZT, VAN, LZ and TEI are the high priority HEA with significant reduction in meropenem usage over the period of time. The recovery rate of patients was found to be 60% with 8% mortality rate.

Conclusion: The usage of HEA was significantly less in wards when compared to CCU. MRP, LZ, VAN and PB were found to be the high priority HEA. Following intervention significant reduction evidenced with TEI, TIG, CL, and FOS.

Keywords: Antimicrobial stewardship, high end antibiotics, restricted antibiotics, antimicrobial trend, defined daily dose and antibiotic consumption.

How to cite this article: Ramakrishnan K, Balaji S, Pandian JJ, Thangaraju S, Poonguzhali S, Babu CPG. Restricted high-end antibiotics monitoring and policy adherence rate in a tertiary care hospital. Int J Drug Deliv Technol. 2026;16(6s): 531-537; DOI: 10.25258/ijddt.16.6s.58

Source of support: None.

Conflict of interest: None