DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20183032

A study on antimicrobial agents utilization pattern using anatomical therapeutic chemical / daily defined dose system and adverse drug reaction pattern in the intensive care unit of a tertiary care teaching hospital in North Eastern state of India

Debasis Ray, Smita Datta

Abstract


Background: Successful use of antibiotics has brought a revolutionary change in the management of infectious diseases but has also resulted in its irrational use. Indiscriminate use of anti-microbial agents (AMAs) has been well-documented in the ICUs where polypharmacy is a common phenomenon, thus increasing the risk of Adverse Drug Reactions (ADRs). It is extremely imperative to evaluate the prescribing pattern of antimicrobials for enabling suitable modifications in prescribing patterns; to increase the therapeutic benefits and for optimizing the health care services.

Methods: With the objective to assess the prescription patterns of AMAs and the rationality of their use this observational study was undertaken in the Intensive Care Unit of a Tertiary Care Hospital for two months.

Results: Of the total 127 patients, 80 (62.99%) were male and 47 (37.01%) were female at an average age of 51.3±18.3 years. 102 (80.31%) patients received AMAs at average of 1.71±0.99 and 25 (19.69%) didn’t. Betalactam antibiotics were the most frequently (72.99 %) prescribed class. Meropenem was the most commonly prescribed (41 occasions) agent. The length of stay in ICU per patient was 4.42±3.49 days. 41.63% patients had more than two morbidities. No AMAs were prescribed in generic name. In 28 (27.45%) patients the AMAs prescribing were irrational.

Conclusions: The high utilization rates of costly AMAs and irrational prescriptions are matters of great concern and need to be urgently addressed by use of guidelines, surveillance and antibiotic restriction policies and sensitization programs at all level of healthcare.


Keywords


Antibiotic utilization, ADR, DDD, ICU, Rationality

Full Text:

PDF

References


Meher BR, Mukharjee D, Udaishankar. J Chem Pharm. Res. 2014;6(7):1847-9.

Anand N, Nayak IMN, Advaitha MV, Thaikattil NJ, Kantanavar KA, Anand S. Ind J Criti Care Medici. 2016;20(5):22-7.

Sachidananda Adiga MN, Alwar MC, Mirabel Pai RSM, Usha S Adiga. Onli J Healt and Alli Scienc. 2009;8(4):1-4.

Pandiamunian J, Somasundaram G. A study on Prescribing Pattern of Anti Microbial Agents in the Medical Intensive care unit of a tertiary care teaching hospital in Puducherry Union Territory, South India. Int J Pharm Pharm Sci. 2014;6(3):235-8.

Badar VA, Navale SB. Study of prescribing pattern of antimicrobial agents in medicine intensive care unit of a teaching hospital in central India. JAPI. 2012;60.

Drupad HS, Nagabushan H, Prakash GM. Prospective and Observational Study of Antimicrobial Drug Utilization in Medical Intensive Care Unit in a Tertiary care Teaching Hospital. Int J Pharm Resear. 2016;6(1):13-7.

Patel SR, Shah AM, Shah RB, Buch JG. Evaluation of drug utilization pattern of antimicrobials using ATC / DDD system in intensive care unit of a tertiary- care teaching hospital. Inte J Med Scien and Publi Healt. 2016;5(1):80-4.

Kathiria JM, Sattigeri BM, Desai PM and Patel SP. A study of adverse drug reactions in patients admitted to intensive care unit of a tertiary care teaching rural hospital. Int J Pharm Pharm Sci. 2013;5(1):160-3.

Saravanan SS, Kavitha P, Ponnuswamy TK. Patterns of Adverse Drug Reactions in the Medical Intensive Care Unit of an Indian Tertiary Care Hospital. Int J Pharmaceu Bio Archiv. 2014;5(3):64-8.

Bansal D, Mangala S, Undela K, Gudula K, D’cruse S, Sachdev A, et al. Measurement of Adult Antimicrobial Drug Use in Tertiary Care Hospital Using Defined Daily Dose and Days of Therapy. Indian J Pharmaceu Scien. 2014;76(3):211-7.

Shelat PR, Gandhi AM, Patel PP. A Study of ine Dose in Drug Utilization Pattern According to Daily Define Dose in Intensive Care Unit (ICU) at Tertiary Care Teaching Hospital, India. J You Pharmacis. 2015;7(4):349-58.

Choudhury DK, Bezbaruah BK. Prescribing Pattern of Analgesic in Orthopedic In-patient Department at Tertiary Care Hospital in Guwahati, Assam, Northeast India. Ind J Pharmacol. 2016;48(4):377-81.

Williams A, Mathai AS, Phillips AS. Antibiotic prescription patterns at admission into a tertiary level intensive care unit in Northern India. J Pharm Bioallied Sci. 2011;3:531‑6.

Patel MK, Barvaliya MJ, Patel TK, Tripathi CB. Drug Utilization Pattern in Critical Care Unit in a Tertiary Care Teaching Hospital in India. Int J Crit Illn Inj Sci. 2013;3(4):250-5.

Mahajan B, Kaushal S, Chopra SC. A drug Utilization study of Antimicrobial agents (AMAs) in the intensive Care Units (ICUs) at Medical College Hospital of North India. J K Science. 2013:15(3):129-32.

John LJ, Devi P, John J, Guido S. Drug utilization study of antimicrobial agents in medical intensive care unit of a tertiary care hospital. Asian J Pharm Clin Res. 2011;4:81‑4.

Alamchandani RR, Khubchandani PR. A Study Evaluating Appropriateness of Utilization Pattern of Antimicrobials in Patients Admitted in Medical Intensive care unit of Tertiary Care Teaching Rural Hospital. Int J Pharm Pharm Sci. 2015;7(5):101-4.

Patanaik SK, Pattanayak C, Prasad A, Chauhan AS. Drug Utilization Pattern in an Intensive Care Unit Setting in Eastern India. Int J Basic Clin Pharmacol. 2015;4(6):1136-41.

Amit GS. Drug use evaluation study in a tertiary care corporate hospital with special reference to use of antibiotics in ICU department. Int J Adv Pharm Biol Chem. 2013;2:179‑89.

Shankar PR, Partha P, Dubey AK, Mishra P, Deshpande VY. Intensive care unit drug utilization in a teaching Hospital in Nepal. Kathmandu Univ Med J. KUMJ. 2005;3:130‑7.

Arathy R, Chacko J, Pillai S, Bhanu A, Raphael R, Jalajakumari M. Drug Utilization in Medical Intensive Care Unit: A Retrospective Analysis from a Tertiary Care Teaching Hospital. Int J Basic Clin Pharmacol. 2016;5(4):1201-4.

Shobha P, Sunitha M. Evaluation of Rational Drug Use Pattern Using WHO Prescribing Indicators in a Medical Intensive Care Unit of a Tertiary Teaching Hospital in Kerala, India. Int J Basic Clin Pharmacol. 2017;6(6):1328-32.

Kaur S, Rajagopalan S, Kaur N, Shafiq N, Bhalla A, Pandhi P, et al. Drug utilization study in medical emergency unit of a tertiary care hospital in North India. Emerg Med Int. 2014;5. Article ID 973578.