Background Burn injuries are a significant public health concern in low‐ and middle‐income countries, associated with high morbidity and mortality due to infections and antimicrobial resistance (AMR). However, data on these aspects from Nepal remain limited. The study aimed to assess antibiotic utilization patterns and cost analysis among burn patients at a tertiary care hospital in Nepal. Methods A retrospective cross‐sectional study was conducted using medical records of 249 burn patients admitted to a tertiary care hospital between June 2018 and May 2019. Antibiotic consumption was assessed using the WHO Anatomical Therapeutic Chemical (ATC) /defined daily dose (DDD) methodology. A generalized linear model (GLM) with a gamma distribution and log‐link function was employed to identify factors influencing antibiotic costs. Results Total antibiotic consumption was 2213. 38 DDDs, corresponding to 82. 47 DDDs per 100 bed‐days. Cephalosporins were the most frequently prescribed class (57. 6%), with ceftriaxone being the most commonly used agent. Empirical therapy was initiated in 55% of cases, and 96. 4% of antibiotics were administered parenterally. Multidrug‐resistant (MDR) and extensively drug‐resistant (XDR) infections were identified in 35. 3% and 14. 5% of patients, respectively. The median antibiotic cost per patient was US18. 18 (IQR: US63. 90). Higher costs were significantly associated with age between 15 and 44 years, greater total body surface area (TBSA) involvement, third‐degree burns, and the presence of MDR/XDR infections (p < 0. 001). Conclusion The study reveals a high rate of empirical antibiotic use and substantial costs in burn care, primarily driven by resistant infections and burn severity. These findings underscore the urgent need for implementing antimicrobial stewardship interventions and culture‐guided therapy to improve clinical outcomes and reduce the financial burden.
Thapa et al. (Thu,) studied this question.