Comparative Drug Utilization of Antimicrobial Agents in Medical and Respiratory Intensive Care Units of a Tertiary Care Teaching Hospital in South India

ABSTRACT

Introduction :Drug Utilization Evaluation play a key role in managing healthcare system to understand, interpret, evaluate and improve the prescribing, administration and use of medications.Objective:To evaluate and compare the drug utilization of antimicrobials in Medical and Respiratory Intensive Care Units so as to include restriction policies. Methods:A prospective, observational study was performed on 209 prescriptions. The total number of drugs, dose, route, sensitivity pattern and cost were collected from in-patient records. The Defined Daily Dose/100 bed days of the most frequently prescribed antimicrobials was also calculated. Results: Out of the 1046 drugs prescribed in the Medical Intensive Care Unit, 167 antimicrobials were prescribed with an average of 2 drugs per prescription. The average length of stay was 4 (±1.4) days. Frequently prescribed antimicrobials were ceftriaxone, amikacin and clindamycin. The DDD/100 bed days for those drugs was 22.2, 6.9 and 5.9 respectively. The widely prescribed combinations were piperacillin+tazobactam and cefoperazone+tazobactam. In only 23% of the cases sensitivity test was performed. The most prevailing organisms were E.Coli (53%) and Acinetobacter sps (23%). Colistin and meropenam were the most sensitive antimicrobials for most microorganisms. In Respiratory Intensive Care Unit, out of 1024 drugs, 163 antimicrobials were prescribed with an average of 2 drugs per prescription. The average length of stay was 4 (±1.4) days. Ceftriaxone (40%) was found to be most commonly prescribed drug followed by clindamycin (17%), levofloxacin (12%) and meropenam (11%). The generally prescribed combination was piperacillin+tazobactam (30%). The DDD/100 bed days was found to be high. In only 20% of the cases sensitivity test was performed. Acinetobacter sps was the most frequently isolated pathogen and all microorganisms were sensitive to colistin. Conclusion:There is a need of anti-microbial agents usage guidelines and restriction policies for the rational prescribing of antimicrobials in critically ill patients.

KEYWORDS

• Drug Use Evaluation
• Antimicrobial Agents
• MICU
• RICU
• Sensitivity pattern
• Defined Daily Dose

Showing references and in-text citations exactly as published.

• DOI10.5530/ijopp.9.2.11Copy

RELATED ARTICLES

Matched on section and article type within this issue of IJPP.

• Article · VOLUME 9, ISSUE 2Systematic mapping of studies published in Indian Journal of Pharmacy Practice from 2008-2015Pramil Tiwari, Ruchi Singhal, Rajiv Ahlawat · pp. 115–122Research ArticleSame type: Article
• Article · VOLUME 9, ISSUE 2Prevalence of Metabolic Syndrome in Hypertensive De Novo Patients at a Tertiary Care HospitalAnusha Govindula, Chandrasekhar Valupadas, Sabitha Panchagiri · pp. 131–135Research ArticleSame type: Article
• Article · VOLUME 9, ISSUE 2Control of Post Prandial Blood Sugar Among the Treatment Patterns for Type 2 Diabetic Mellitus: A Retrospective StudyMalarkodi Velraj, G. Ragesh, Poripiraddy Satya Prasad · pp. 136–138Research ArticleSame type: Article
• Article · VOLUME 9, ISSUE 2Sustainable Development Goals and Addressing Noncommunicable DiseasesSeema Rath, Shraddha Patnala, Sean James Bosman, Sunitha Srinivas · pp. 66–72Same type: Article