Prescribing pattern of antimicrobial agents in intensive care unit of a teaching hospital in Central India
Keywords:Antimicrobial agents, Intensive care unit, Prescribing pattern
Background: Patients admitted to the Intensive care unit (ICU) receive multiple medications from a variety of pharmacological classes due to various life threatening illness and co-morbidities. The present study aims to evaluate the current usage of anti-microbial agents (AMAs) in the ICU of a teaching hospital in central India.
Methods: A prospective observational study was carried out at the 11 bedded medical ICU of R. D. Gardi Medical College and Hospital, Ujjain (M.P.) for a period of 3 months from Aug 2012 to Oct 2012. The relevant data on drug prescription of each patients was collected from the inpatient case record. The demographic data, disease data and the utilization of different AMAs were analyzed.
Results: A total of 1671 drugs out of which 343 AMAs were prescribed in 148 patients (male-78, female-70) studied, that is, an average of 11.3drugs/patients and 2.32 AMAs/patients. In ICU cefotaxime was the most commonly used AMAs in 17.5% patients, followed by metronidazole in 14% patients and ciprofloxacin in 8.8% patients. Most common indication for the anti-microbial therapy was infection (51.4%). 80.4% patients were given 1-3 AMAs, 19.6% patients were given 4-9 AMAs. amoxicillin+clavulanic acid was the most common FDC noticed.
Conclusions: Interventional programme should focus on infection control with rational antibiotic prescription aimed at minimizing unnecessary cost, adverse drug reaction and emergence of bacterial resistance.
Krivoy N, El-Ahal WA, Bar-Lavie Y, Haddad S. Antibiotic prescription and cost patterns in a general intensive care unit. Pharmacy Practice. 2007;5(2):67-73.
Niederman MS. Appropriate use of antimicrobial agents: challenges and strategies for improvement. Crit Care Med. 2003 Feb;31(2):608-16.
Kollef MH. Optimizing antibiotic therapy in the intensive care unit setting. Crit Care. 2001;5:189-95.
Pulcine C, Pradier C, Samat-Long C, Hyvernat H. J Antimicrob Chemother. 2006;57:546-50.
Bassetti M, Di Biagio A, Rebesco B, Amalfitano ME, Topal J, Bassetti D. The effect of formulary restriction in the use of antibiotics in an Italian hospital. Eur J Clin Pharmacol. 2001;57:529-34.
Esposito S, Leone S. Antimicrobial treatment of Intensive Care Unit (ICU) infections including the role of the infectious diseases specialist. Int J Antimicrob Agents. 2007;29:494-500.
Lockhart SR, Abramson MA, Beekman SE, Gallagher G, Riedel SR, Diekma D J, et al. Antimicrobial Resistance among gram negative bacilli as causes of Infections in ICU patients in the United States between 1993 and 2004. J Clin Microbiol. 2007;45:3352-9.
Williams A, Mathai AS, Phillips AS. Antibiotic prescription patterns at admission into a tertiary level intensive care unit in Northen India. J Pharm Bioall. Sci. 2011;3:531-6.
Tavallaee M, Fahimi F, Kiani S. Drug-use patterns in an intensive care unit of a hospital in Iran: An observational prospective study. Int J Pharm Pract. 2010;18:370- 6.
Biswal S, Mishra P, Malhotra S, Puri GD, Pandhi P. Drug Utilization Pattern in the intensive care unit of a tertiary care hospital. J Clin Pharmacol. 2006;46:945-51.
Hanssens Y, Ismaeil BB, Kamha AA, Elshafie SS, Adheir FS, Saleh TM, et al. Antibiotic prescription pattern in a medical Intensive care unit in Qatar. Saudi Med J. 2005;26:1269-76.
Hariharan S, Pillai G, McIntosh D, Bhanji Z, Culmer L, Harper-McIntosh K. Prescribing patterns and utilization of antimicrobial drugs in a tertiary care teaching hospital of a Caribbean developing country. Fundam Clin Pharmacol. 2009;23:609-15.
Vandana AB, Sanjaykumar BN. study of prescribing pattern of antimicrobial agents in medicine intensive care unit of a teaching hospital in central india. JAPI. 2012 april;60:20-3.
Pandiamunian J, Somasundaram G. A study of prescribing pattern of Antimicrobial 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.