Prescribing Pattern of Antibiotics and Analgesics for Postoperative Patients in the Department of Orthopaedic: A Prospective Observational Study at a Tertiary Care Teaching Hospital, Mandya, Karnataka, India

Background: Postoperative care in orthopedic patients often involves the use of antibiotics and analgesics to prevent infections and manage pain. Rational prescribing in accordance with the world health organization(WHO) prescribing indicators is essential to ensure patient safety and optimal outcomes. Study on prescribing pattern of antibiotics and analgesics for postoperative patients in the department of orthopedics was conducted at MIMS Hospital, Mandya, Karnataka. AIM: To assess the prescribing patterns of analgesics and antibiotics and other supportive medications in postoperative orthopedic patients and assess compliance with WHO prescribing indicators.
Methodology: A prospective observational study was conducted in the department of orthopedics at a tertiary care teaching hospital in Mandya. A total of 300 postoperative patients were included using consecutive sampling method over predefined period. Data on demographic details, type of surgery, medications prescribed, duration of hospital stay and WHO prescribing indicators were collected and analyzed.
Result: Out of 300 patients, 206 were males (68.6%) and 94 were females (31.3%). The majority belonged to the 50–59 years age group. Self-fall (82.6%) was the leading cause of injury, with fractures (88.3%) being the predominant diagnosis. The most common surgeries were CRIF (36.6%) and ORIF (28%). The average hospital stay was 4.82 ± 0.96 days. A total of 1847 drugs were prescribed, of which analgesics (44.1%) were most frequent, followed by antibiotics (22.1%), supplements (18.0%), and gastroprotective agents (15.7%). WHO indicators revealed polypharmacy (average 6.15 drugs per prescription), 100% encounters with antibiotics and injections, 98% generic prescribing, and 51.3% use of essential medicines. Cephalosporins, particularly Cefixime (40.2%) and Ceftriaxone + Sulbactam (31.5%), were the most prescribed antibiotics. Analgesics were predominantly paracetamol (34%), aceclofenac + serratiopeptidase (32.6%), and tramadol (31.6%). Supplements were mainly calcium (24.3%) and B-complex vitamins (20.6%). DVT prophylaxis was given to 23.3% of patients, primarily with LMWH + aspirin.
Conclusion: Postoperative management in orthopedics relied heavily on analgesics and cephalosporins, with rational antibiotic use but excessive injection prescribing. Strengthening adherence to essential medicines and promoting oral formulations can improve rational drug use and cost-effectiveness.