Assessing the Prescription Pattern of Antimicrobial Agents in Intensive Care Unit at Tertiary Care Hospital

2020 ◽  
Vol 2 (10) ◽  
pp. 1825-1830
Author(s):  
Avinash Khadela ◽  
Bhavin Vyas ◽  
Nancy Rawal ◽  
Heni Patel ◽  
Sonal Khadela ◽  
...  
Author(s):  
DUDHE BG ◽  
CHAKRAVORTY ASHISH D ◽  
MANKAR NN ◽  
PISE HN

Objective: The objective of the study was to assess the current use of antimicrobial agents (AMAs) and to assess prescription writing as per the WHO guidelines in the medicine intensive care unit (MICU). Methods: The present study was conducted on admitted patients in MICU of a tertiary care hospital. The demographic and clinical treatment data of patients were collected in specially designed pro forma from the case record form. Results: Of 400 patients enrolled in the study, 55.50% were male and 44.50% were female. A common indication of AMAs use was infection (61.75%), symptomatic (21.50%), and prophylactic (10.50%) use. In 65% patients, antimicrobial therapy was considered to be rational. The majority of patients have good recovery (61%). Polypharmacy was seen in 89.75% of patients. The average number of drugs prescribed per patient was 8.84±2.55. 1.90±1.20 was average number of AMAs per patient. Commonest AMAs prescribed are ceftriaxone (27.64%), metronidazole, and amoxicillin+clavulanic acid. Conclusion: This study visibly highlights the practice of polypharmacy, low uses of generic drugs, high usage of antibiotic, and injection. Cephalosporins are the most prescribed AMAs in the ICUs. Remedy of this situation requires regulation, education, awareness, compliance with protocol, and guidelines of AMAs use.


Author(s):  
Nimin Paul ◽  
Santhosh Kumar V

 Objective: To identify the pattern of drug utilization of antimicrobials in prescriptions of patients admitted at medical intensive care unit (MICU) and surgical intensive care unit (SICU) department and to analyze the utilization of different classes of drugs.Methods: A prospective observational study was carried out in 10 bedded medical and surgical intensive care unit (ICU) of tertiary care hospital, Adayar, from October 1st 2016 to March 1st 2016. The study was performed in 100 prescriptions. The relevant data on drug prescription of each patient were collected from in-patient records. The demographic data, disease data, and the utilization of different classes of antimicrobial agents (AMAs) were analyzed.Results: In MICU, a total of 648 drugs were prescribed during the period of stay and AMAs accounted for 15% of total drug. The average length of stay was found to be 8 (±8.73). The mean number of drugs received by patients is 11.6 ± 2 drugs. The most frequently prescribed AMAs were ceftriaxone followed by meropenem and clindamycin. Cephalosporin is commonly prescribed due to their relatively lower toxicity and broader spectrum activity. The generally prescribed AMA combination was amoxicillin + clavulanic acid (32.50%) and piperacillin + tazobactam (27.50%). The laboratory reported positive cultures for 30 patients. The most prevailing organisms were Escherichia coli (50%). In SICU, a total of 780 drugs were prescribed during the period of stay and AMAs accounted for 18% of total drug. An average of 5 (±2.0) drugs was prescribed for each patient and each prescription contains an average of 2 (±0.9) AMAs. The results indicated that ceftriaxone was the most commonly prescribed AMAs (22%), followed by meropenem (18%), ciprofloxacin (18%), and colistin (8%). A total of five AMA combination therapies were used in SICU. Among them, piperacillin+clavulanic acid (36.84%) was the most commonly prescribed combination. In the study, 30 (60 %) cases had microbial growth and have performed sensitivity test.Conclusion: A wide class and percentage of AMAs were prescribed in ICUs. There is a need of antimicrobial agent’s usage guidelines and restriction policies for the rational prescribing of antimicrobials in critically ill patients.


Author(s):  
Nimin Paul ◽  
Santhosh Kumar V

 Objective: To identify the pattern of drug utilization of antimicrobials in prescriptions of patients admitted at medical intensive care unit (MICU) and surgical intensive care unit (SICU) department and to analyze the utilization of different classes of drugs.Methods: A prospective observational study was carried out in 10 bedded medical and surgical intensive care unit (ICU) of tertiary care hospital, Adayar, from October 1st 2016 to March 1st 2016. The study was performed in 100 prescriptions. The relevant data on drug prescription of each patient were collected from in-patient records. The demographic data, disease data, and the utilization of different classes of antimicrobial agents (AMAs) were analyzed.Results: In MICU, a total of 648 drugs were prescribed during the period of stay and AMAs accounted for 15% of total drug. The average length of stay was found to be 8 (±8.73). The mean number of drugs received by patients is 11.6 ± 2 drugs. The most frequently prescribed AMAs were ceftriaxone followed by meropenem and clindamycin. Cephalosporin is commonly prescribed due to their relatively lower toxicity and broader spectrum activity. The generally prescribed AMA combination was amoxicillin + clavulanic acid (32.50%) and piperacillin + tazobactam (27.50%). The laboratory reported positive cultures for 30 patients. The most prevailing organisms were Escherichia coli (50%). In SICU, a total of 780 drugs were prescribed during the period of stay and AMAs accounted for 18% of total drug. An average of 5 (±2.0) drugs was prescribed for each patient and each prescription contains an average of 2 (±0.9) AMAs. The results indicated that ceftriaxone was the most commonly prescribed AMAs (22%), followed by meropenem (18%), ciprofloxacin (18%), and colistin (8%). A total of five AMA combination therapies were used in SICU. Among them, piperacillin+clavulanic acid (36.84%) was the most commonly prescribed combination. In the study, 30 (60 %) cases had microbial growth and have performed sensitivity test.Conclusion: A wide class and percentage of AMAs were prescribed in ICUs. There is a need of antimicrobial agent’s usage guidelines and restriction policies for the rational prescribing of antimicrobials in critically ill patients.


Author(s):  
Shiraz Mirza Baig ◽  
Imran B. Naikwadi ◽  
L. S. Deshmukh

Background: Recurrent and prolonged courses of antibiotics exposure have resulted in an increase in the prevalence of hospital acquired infections and antibiotic resistant profile. The objective of this study was to quantify the use of antibiotics in a neonatal intensive care unit (NICU) of Govt. Medical College and Hospital, Aurangabad, Maharashtra, a tertiary health care centre.Methods: A total of 260 neonates admitted in NICU from August 2017 to February 2018 were enrolled in the study and fulfilling inclusion criteria of the study. Demographic details, data on antibiotic prescriptions (name, dose, frequency, route of administration) was recorded on pre-tested structured Performa.Results: A total of 248 neonates received the antibiotics. EOS pneumonia was most common i.e. 29.8% followed by LOS pneumonia (20.6%). Sepsis, pneumonia Meningitis, NEC, were common indications for admission in NICU. Among the antibiotic combinations amoxicillin + clavulanate (38.99%), was most commonly prescribed followed by gentamicin (37.89%) and piperacillin (11.01%) respectively. Other antibiotics like, linezolide (0.94%), fluconazole (5.97%), meropenem (4.42%), vancomycine (0.77%) were also used less commonly in NICU. About fifty of the medicine prescribed were in compliance with the national list of essential medicines 2011.Conclusions: In tertiary care setup of NICU amoxicillin + clavulanate and gentamicin are most commonly used antibiotics in NICU. The study concludes that the antibiotic prescription pattern at NICU of our tertiary care hospital was found rational.


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