Abstract
Background: Irrational prescribing of antibacterial is one of the major causes of development of antibacterial resistance, adverse drug reaction, and increased economic burden on health. Prescribing indicators are the best tool to assess the rational use of antibacterial as suggested by the World Health Organization (WHO). This study to assess the prescribing practices and pattern of antibacterial agent in tertiary care hospital in hilly state Uttarakhand was conducted as a bed rock for introducing the antibiotic stewardship program.

Aims and Objectives: To assess the prescribing pattern and practices of antibacterial and to provide starter for recommendations to the introduction of antimicrobial stewardship programme at our tertiary care center.

Materials and Methods: The study was conducted from August 2022 to October 2022. It was an outpatient department based descriptive, cross sectional, prospective study. Prescription order generated with at least one medication was reviewed according to the WHO prescribing indicators and classified according to the WHO AWaRe classification and evaluated in line with Uttarakhand essential medicine list 2015 latest only available on public domain.

Results: During the study, a total of 601 prescriptions were analyzed, in which 62.89% were female and 37.1% were males and most of the patients were of 15–64 years age group. Drugs prescribed by their generic name were 67.41% and majority of drug prescribed were from Uttarakhand essential drug list 2015 which is latest available on public domain. The average no of dug per encounter was higher (3.6 ± 1.6) than optimal 1.6–1.7 endorsed by the WHO. Out of all, only 1.1% of prescribed drugs were injectable. The most commonly used antibacterial was cefixime. The access group of antibiotics was accounting for 43% of total antibiotics.

Conclusion: Our study demonstrates that prescribing practices assessed by WHO prescribing indicators showed deviation from the WHO set standards. The study revealed polypharmacy and a comparatively smaller number of drugs prescribed with a generic name and from the Uttarakhand essential medicine list 2015 (latest). This study provides evidence for future guidelines and recommendations and a way forward for the establishment of an antibacterial stewardship program in our hospital.

Key words: Prescribing Indicators; Antibacterial; Uttarakhand; AWaRe Classification