To study the prescription pattern of antibiotics in medicine intensive care unit at tertiary care hospital
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20191109Keywords:
Antibiotics, Drug utilization, MICUAbstract
Background: Drug utilization studies are crucial and create a positive awareness about proper use of drugs. Analysing the pattern of prescriptions is important in the settings of intensive care units where patients receive multiple antibiotics. The objective of this study was to analyse the use of antibiotics in a Medicine Intensive Care Unit (MICU) of Government Medical College and Hospital, Aurangabad, Maharashtra, India, a tertiary health care centre.
Methods: Total 988 number of patients admitted in MICU from January 2017 to June 2018 were enrolled in the study and fulfilling inclusion criteria. Demographic details, disease state and prescription of antibiotic was recorded.
Results: Out of 988, n=700 patients received antibiotics. Most common diseases for which patients were admitted in MICU included OP poisoning (24.86%), snake bite (15.14%), bilateral pneumonitis (12.71%), HELLP syndrome (12.14%), and the least common conditions were chronic obstructive pulmonary disease (COPD), meningitis, sepsis with multiple organ dysfunction syndrome (MODS), Guillen barre syndrome (GBS), lung abscess etc., Most common single antibiotic used in the studied cases was ceftriaxone (21.42%) followed by either alone or in combination piperacillin and tazobactam (12.04%), metronidazole (11.85%) etc.
Conclusions: Total 700 patients received systemic antibiotics in present study bringing the incidence of systemic antibiotics use in MICU to be 70.85%. Ceftriaxone and combination of piperacillin and tazobactam are most commonly used antibiotics in MICU of the hospital. All patients admitted in this MICU received antibiotics as per the standard protocols of the hospital.
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References
Mittal N, Mittal R, Singh I, Shafiq N, Malhotra S. Drug utilisation study in a tertiary care center: recommendations for improving hospital drug dispensing policies. Indian J Pharm Sci. 2014;76(4):308-14.
Gould IM, Bal AM. New antibiotic agents in the pipeline and how they can overcome microbial resistance. Virulence. 2013;4(2):185–191
Chant C, Leung A, Friedrich JO. Optimal dosing of antibiotics in critically ill patients by using continuous/extended infusions: a systematic review and meta-analysis. Crit Care. 2013 Nov 29;17(6):R279.
Murray MJ, Coursin DB. Multiple organ dysfunction syndrome. Yale J Biol Med. 1993;66(5):501-10.
Roca I, Akova M, Baquero F, et al. The global threat of antimicrobial resistance: science for intervention. New Microbes New Infect. 2015;6:22-9. Published 2015 Apr 16.
Lighthall GK, Vazquez-Guillamet C. Understanding Decision Making in Critical Care. Clin Med Res. 2015;13(3-4):156-68.
Curcio D, Latin American Antibiotic Use in Intensive Care Unit Group. Antibiotic prescriptions in critically-ill patients: a latinamerican experience. Ann Med Health Sci Res. 2013;3(2):220-8.
Radji M, Fauziah S, Aribinuko N. Antibiotic sensitivity pattern of bacterial pathogens in the intensive care unit of Fatmawati Hospital, Indonesia. Asian Pac J Trop Biomed. 2011;1(1):39-42.
Johnston D, Razeeya Khan, Jacqui Miot ORCID Icon, ShirraMoch, Yolande van Deventer & Guy Richards Usage of antibiotics in the intensive care units of an academic tertiary-level hospital Pages Southern African Journal of Infectious Diseases Volume 33, 2018 - Issue 4106-113
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(4):531-6.
Anand N, NagendraNayak IM, Advaitha MV, Thaikattil NJ, Kantanavar KA, Anand S. Antimicrobial agents’ utilization and cost pattern in an Intensive Care Unit of a Teaching Hospital in South India. Indian J Crit Care Med. 2016;20:274–79.
Perveen R A ,Morshed Nasir , Nadia Farha and Mohammad Ashraful Islam Antibiotics in ICU: The Challenges of Use, Cost and Response in a Tertiary Care Hospital Int J Med Res Health Sci 2018, 7(6): 94-99
Mangrulkar SV, Mangrulkar S, Khair P, Phalke A. Antibiotic use in the intensive care unit. J Assoc Physicians India. 2012 Apr;60:15-8.
Atila Kara, İsa Sahar, Mehmet NezirGüllü, KezbanÖzmenSüner, KazımRollas, BurçinHalaçlı, ArzuTopeliThe Characteristics of Antibiotic Use and Changing Patterns in an Intensive Care Unit YoğunBakımDerg 2016; 7: 53-6
Mondal K, Biswas S, Ghosh A, Dalui SK, Datta A, Biswas S. Rationality of utilization of antimicrobial agents in medical intensive care unit of a tertiary care hospital. Int J Basic ClinPharmacol2016;5:2168-73.
Adrie C, Schwebel C, Garrouste-Orgeas M, et al. Initial use of one or two antibiotics for critically ill patients with community-acquired pneumonia: impact on survival and bacterial resistance. Crit Care. 2013;17(6):R265. Published 2013 Nov 7.
Shallcross L, Beckley N, Rait G, Hayward A, Petersen I. Antibiotic prescribing frequency amongst patients in primary care: a cohort study using electronic health records. J AntimicrobChemother. 2017;72(6):1818-1824.
Maharani B, A. LourduJafrin , M. Prakash , P. Priyadarshini Prescription pattern of patients admitted in the intensive care unit of a tertiary care hospital in Puducherry, India: a cross sectional study International Journal of Basic & Clinical Pharmacology December 2017 Vol 6 Issue 12 Page 2823
Malacarne P, Rossi C, Bertolini G; GVT Group. Antibiotic usage in intensive care units: a pharmaco-epidemiological multicentre study. J AntimicrobChemother. 2004 Jul;54(1):221-4. Epub 2004 Jun 9.
Ahmed A, Azim A, Gurjar M, Baronia AK. Current concepts in combination antibiotic therapy for critically ill patients. Indian J Crit Care Med. 2014;18(5):310-4.
Chokshi R, Restrepo MI, Weeratunge N, et al. Monotherapy versus combination antibiotic therapy for patients with bacteremic Streptococcus pneumoniaecommunity-acquired pneumonia. Eur J ClinMicrobiol Infect Dis 2007;26(7): 447–51
ErbayE.AkıncıA.Çolpan Evaluation of antibiotic use in intensive care units of a tertiary care hospital in Turkey Journal of Hospital Infection Volume 59, Issue 1, January 2005, Pages 53-61
Durgad AG, Varadarajan S. Prevalence of NI in the intensive care unit .Int J Res Med Sci 2015;3:3514-8.
Zilahi G, McMahon MA, Povoa P, Martin-Loeches I. Duration of antibiotic therapy in the intensive care unit. J Thorac Dis. 2016;8(12):3774-3780.
