Background: Critically ill patients admitted to intensive care units (ICUs) are highly susceptible to infections because of predisposing illnesses and the use of invasive and surgical procedures and are, therefore, exposed to high antimicrobial pressure. Use of antimicrobials in the ICU must follow best clinical practice if the emergence of resistance to antimicrobials is to be minimized.
Objective: To evaluate the antimicrobial prescription patterns in the ICU.
Materials and Methods: A prospective observational study was undertaken from April 2014 to September 2014 in a tertiary-care teaching hospital. All the patients admitted in ICU were included in the study. Relevant data such as demographic parameters, clinical data, drug use, and antimicrobial use were collected every day till patients were discharged from ICU using their case record sheets. Antimicrobial use was analyzed using Anatomical Therapeutic Chemical (ATC) Classification/defined daily dose (DDD) system, and DDD/100 bed-days were calculated for antimicrobials.
Result: Totally, 123 patients admitted into the ICU were included in the study. This included 75 men and 48 women. The average age of the patients was 56.7 years (±SD = 19.9 years). Majority of the patients admitted to the ICU were from the medical specialty (96, 78.05%). One hundred thirteen patients (91.87%) were prescribed an antimicrobial with an average of 1.49 (±0.79) antimicrobials per prescription. Majority of the patients (107; 94.69%) were prescribed the antimicrobials prophylactically. Ceftriaxone (J01DD04) was the most commonly (69; 61.60) prescribed antimicrobial agent with DDD/100 bed-days value of 11.86, followed by amoxicillin + clavulanate (J01CR02) with DDD/100 bed-days value of 5.42.
Conclusion: The need for antimicrobial should be reviewed daily on every patient, always stopping at the earliest possible opportunity where the benefits of continuing are outweighed by the drawbacksboth to that patient and to the unit as a whole in terms of its microbial ecology.
Key words: Antimicrobials; intensive care unit (ICU); drug utilization; ATC/DDD classification
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