Background and Aims:High utilization and inappropriate usage of antimicrobial agents (AMAs) in an Intensive Care Unit (ICU) increases resistant organisms, morbidity, mortality, and treatment cost. Prescription audit and active feedback are a proven method to check the irrational prescription. Measuring drug utilization in DDD/100 bed-days is proposed by the WHO to analyze and compare the utilization of drugs. Data of AMAs utilization are required for planning an antibiotic policy and for follow-up of intervention strategies. Hence, in this study, we proposed to evaluate the utilization pattern and cost analysis of AMA used in the ICU.Methodology:A prospective observational study was conducted for 1 year from January 1, 2014, to December 31, 2014, and the data were obtained from the ICU of a tertiary care hospital. The demographic data, disease data, relevant investigation, the utilization of different classes of AMAs (WHO-ATC classification) as well as individual drugs and their costs were recorded.Results:One thousand eight hundred and sixty-two prescriptions of AMAs were recorded during the study period with an average of 1.73 ± 0.04 prescriptions/patient. About 80.4% patients were prescribed AMAs during admission. Ceftriaxone (22.77%) was the most commonly prescribed AMA followed by piperacillin/tazobactam (15.79%), metronidazole (12%), amoxicillin/clavulanic acid (6.44%), and azithromycin (4.34%). Ceftriaxone, piperacillin/tazobactam, metronidazole, and linezolid were the five maximally utilized AMAs with 38.52, 19.22, 14.34, 8.76, and 8.16 DDD/100 bed-days respectively. An average cost of AMAs used per patient was 2213 Indian rupees (INR).Conclusion:A high utilization of AMAs and a high cost of treatment were noticed which was comparable to other published data, though an increased use of newer AMAs such as linezolid, clindamycin, meropenem, colistin was noticed.
Background: The objective of this study was to understand cardiologists’ perspectives on heart failure (HF) management with an emphasis on heart rate (HR) optimization and practice patterns among different medical specialties. Methods: A digital, cross-sectional, questionnaire-based survey involving 149 Indian cardiologists who were experienced in the management of patients with HF in their clinical practice was conducted. The survey questionnaire included 53 items divided into five sections. Responses were analyzed and data were represented as summary statistics. Results: According to most cardiologists, majority of patients belong to the New York Heart Association (NYHA) categories II and III, with ischemia being the most prevalent cause of HF. For patients with HF with reduced ejection fraction (HFrEF), HR>70 beats per minute and sinus rhythm, 38.9% of clinicians strongly agreed to include ivabradine in the treatment regimen. According to 56.4% of clinicians, 26%-50% of patients with HFrEF were receiving ivabradine therapy at <50% guideline-directed target dose of β-blockers. At the highest therapeutic dosage of ivabradine, 46.3% of clinicians noticed a 6-10 bpm reduction in HR. Additionally, it was reported that a stable HFrEF patient consumed an average of 4-6 tablets daily (67.1%), which increased the pill burden. Overall, 58.4% and 67.1% of clinicians strongly believed that cutting back on medications will assist with therapy adherence and that improved therapy adherence and compliance aid with clinical outcomes, respectively. Majority of the clinicians strongly agreed or agreed that patients should be switched from twice-daily to once-daily ivabradine. Conclusions: Clinical outcomes of patients with HF could be improved by reducing the pill burden and improving compliance.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.