Abstract

CONSUMPTION OF HIGH-END ANTIBIOTICS IN AN INTENSIVE CARE UNIT OF A TERTIARY CARE HOSPITAL: A RETROSPECTIVE COMPARATIVE STUDY

*Dr. Jose John

Abstract

Background: High utilization and inappropriate usage of antimicrobial agents (AMAs) in an Intensive Care Unit increases resistant-organisms, morbidity, mortality and treatment cost. Evaluating drug utilization plays a key role in managing health care system to understand, interpret, evaluate and improve the prescribing, administration and use of medication. The Parameter: Defined Daily Dose/100 beds, as proposed by WHO, provides an estimate of consumption of drugs within the hospital in-patients. Methodology: A retrospective comparative study was conducted in the Medical ICU of a tertiary care hospital every 6-months for 1.5 years (January 1 2017 to June 30 2018). The demographic data, disease data and utilization of different classes of High-End AMAs were recorded. Data were sorted in Microsoft Excel using Restricted Antibiotic Form. By using WHO-AMC tool. Results: 3121 patients were admitted for the entire study period, in which 1682 patients received at least one high end AMAs. During consecutive 6-months 722, 833 & 745 high-end prescriptions were obtained respectively. Piperacillin-Tazobactum was the most commonly prescribed antibiotic, followed by Meropenem, Linezolid and Vancomycin. The DDD/100 bed days for restricted antibiotics in consecutive 6 months was found to be 30.854, 35.047, and 31.821 respectively. Conclusion: High utilization of AMAs was observed, which was then compared between each 6-months as well as other published data. The programmed implementation of Antibiotic Stewardship strategies helped to reduce the increasing antimicrobial usage and inappropriate prescription of High-end antibiotics within the ICU-settings.

Keywords: Antimicrobial Consumption, Defined Daily Dose, Retrospective, Restricted Antibiotic, Stewardship.