{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:48:59Z","timestamp":1787071739122,"version":"build-2736575974"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n Antimicrobial stewardship programs typically focus on inhospital settings, with limited information available on the quality of antimicrobial use in hospital outpatient clinics. Given the significant volume of antibiotic consumption in outpatient settings, effective surveillance and identification of target areas should be prioritized as a strategic plan to optimize antimicrobial use.<\/jats:p>\n <\/jats:sec>\n \n Methodology:<\/jats:title>\n Prescriptions of the patients attending outpatient clinics of a tertiary care hospital containing at least one systemic antimicrobial agent (AMA) were screened. Patients\u2019 clinical and demographic data were entered into the case record form. Appropriateness of antimicrobial prescribing was defined as being in accordance with the ICMR standard treatment guidelines. Logistic regression analysis was used to assess the association between various independent variables with the appropriateness of prescribing.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n 35.34% (422\/1194) of the outpatient prescriptions contained at least one AMA. Moreover, 36.96% (156\/422) of the prescriptions containing antimicrobials deviated from the standard treatment guideline. Prescriptions for upper respiratory tract infections (URTIs) (115\/156) (\n P<\/jats:italic>\n < 0.0001) and prescriptions written by intern doctors (\n P<\/jats:italic>\n < 0.0001) were significantly associated with inappropriate prescribing. Overall amoxicillin\u2013clavulinic acid was the most commonly prescribed AMA in the outpatient setting and azithromycin was the most inappropriately prescribed AMA.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Outpatient settings are a crucial component for the implementation of antibiotic stewardship strategies. Prescriptions for URTIs and those prescribed by intern doctors could be identified as high-priority conditions for intervention.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/picr.picr_226_25","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T07:00:11Z","timestamp":1765177211000},"page":"151-155","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Surveillance of antimicrobial utilization among outpatient settings of a tertiary care hospital"],"prefix":"10.4103","volume":"17","author":[{"given":"Niyati","family":"Trivedi","sequence":"first","affiliation":[{"name":"Department of Pharmacology, Medical College Baroda, Vadodara, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janki","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Medical College Baroda, Vadodara, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhara","family":"Naik","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Medical College Baroda, Vadodara, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashant C.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Medical College Baroda, Vadodara, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilima","family":"Kshirsagar","sequence":"additional","affiliation":[{"name":"Department of Health Research, Ministry of Health and Family Welfare, V. Ramalingaswami Bhawan, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"R1-20260710","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1093\/cid\/ciw217","article-title":"Executive summary: Implementing an antibiotic stewardship program: Guidelines by the infectious diseases society of America and the Society for Healthcare Epidemiology of America","volume":"62","author":"Barlam","year":"2016","journal-title":"Clin Infect Dis"},{"key":"R2-20260710","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6506a1","article-title":"Core elements of outpatient antibiotic stewardship","volume":"65","author":"Sanchez","year":"2016","journal-title":"MMWR Recomm Rep"},{"key":"R3-20260710","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1086\/665010","article-title":"Policy statement on antimicrobial stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS)","volume":"33","author":"Fishman","year":"2012","journal-title":"Infect Control Hosp Epidemiol"},{"key":"R4-20260710","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1093\/jac\/dks445","article-title":"A national evaluation of antibiotic expenditures by healthcare setting in the United States, 2009","volume":"68","author":"Suda","year":"2013","journal-title":"J Antimicrob Chemother"},{"key":"R5-20260710","first-page":"1","year":"2014","journal-title":"English Surveillance Programme for Antimicrobial Utilisation and Resistance Report 2014"},{"key":"R8-20260710","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/0168-8510(95)90068-3","article-title":"How to investigate drug use in health facilities. Selected drug use indicators","volume":"34","author":"Ghei","year":"1995","journal-title":"Health Policy (New. York)"},{"key":"R9-20260710","doi-asserted-by":"crossref","first-page":"1928","DOI":"10.1186\/s40064-016-3615-1","article-title":"WHO\/INRUD prescribing indicators and prescribing trends of antibiotics in the accident and emergency department of Bahawal Victoria Hospital, Pakistan","volume":"5","author":"Atif","year":"2016","journal-title":"Springerplus"},{"key":"R12-20260710","first-page":"111","journal-title":"Using Indicators to Measure Country Pharmaceutical Situations: Fact book on WHO Level I and Level II monitoring indicators"},{"key":"R14-20260710","first-page":"1","article-title":"Antibiotic prescribing in inpatient and outpatient settings in Iran: a systematic review and meta-analysis study","volume":"10","author":"Nabovati","year":"2021","journal-title":"Antimicrob Resist Infect Control [Internet]"},{"key":"R15-20260710","doi-asserted-by":"crossref","first-page":"574","DOI":"10.3390\/antibiotics11050574","article-title":"Antibiotic use before, during, and after seeking care for acute febrile illness at a hospital outpatient department: A cross-sectional study from rural India","volume":"11","author":"Holloway","year":"2022","journal-title":"Antibiotics (Basel)"},{"key":"R16-20260710","doi-asserted-by":"crossref","first-page":"61","DOI":"10.4103\/picr.picr_22_22","article-title":"Assessment of use of World Health Organization access, watch, reserve antibiotics and core prescribing indicators in pediatric outpatients in a tertiary care teaching hospital in Eastern India","volume":"14","author":"Mandal","year":"2023","journal-title":"Perspect Clin Res"},{"key":"R18-20260710","doi-asserted-by":"crossref","first-page":"28068","DOI":"10.1038\/s41598-024-78111-0","article-title":"Antimicrobial stewardship implementation in primary and secondary tier hospitals in India: interim findings from a need assessment study using mixed method design","volume":"14","author":"Debnath","year":"2024","journal-title":"Sci Rep"},{"key":"R19-20260710","doi-asserted-by":"crossref","first-page":"2445","DOI":"10.1093\/jac\/dkt223","article-title":"A systematic review of antibiotic utilization in China","volume":"68","author":"Yin","year":"2013","journal-title":"J Antimicrob Chemother"},{"key":"R22-20260710","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.4103\/jfmpc.jfmpc_275_19","article-title":"India's National Action Plan for antimicrobial resistance \u2013 An overview of the context, status, and way ahead","volume":"8","author":"Ranjalkar","year":"2019","journal-title":"J Family Med Prim Care"}],"container-title":["Perspectives in Clinical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/picr.picr_226_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:53:00Z","timestamp":1787068380000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/picr.picr_226_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,4]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/picr.picr_226_25","relation":{},"ISSN":["2229-3485","2229-5488"],"issn-type":[{"value":"2229-3485","type":"print"},{"value":"2229-5488","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,4]]},"assertion":[{"value":"2025-07-14","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}