Antibiotic prescription patterns at admission into a tertiary level intensive care unit in Northern India

Abstract

Context:An audit of antibiotic prescribing patterns is an important indicator of the quality and standard of clinical practice.Aims:To study the (1) antibiotic prescription and consumption patterns at admission into the intensive care unit (ICU); (2) average costs of antibiotics prescribed; and (3) correlation of antibiotic usage and the costs incurred with age, severity of illness, and diagnosis.Settings and Design:A 13-bedded tertiary level ICU. A prospective, observational audit.Materials and Methods:Two hundred consecutive prescriptions on patients admitted to the ICU from August to October, 2008, were audited. The total number of drugs and antibiotics, the class, dose, route, and cost of antibiotics were noted and the Defined Daily Dose/100 bed-days (DDD/100 bed-days) of the 10 most frequently prescribed antibiotics were calculated. Statistical analysis used: Univariate analysis was performed using Epi Info software (version 8.0).Results:A total of 1246 drugs and 418 antibiotics were prescribed in the 200 patients studied, that is, an average of 6.23 (± SD 2.73) drugs/prescription and 2.09 (± SD 1.27) antibiotics/prescription. Antibiotics were prescribed on 190 patients (95%) at admission. There was a significant correlation between the number of patients prescribed three or more antibiotics and mortality rates (53% nonsurvivors vs. 33.5% survivors (P = 0.015). The average cost of the antibiotics was Rupees 1995.08 (± SD 2099.99) per patient and antibiotics expenditure accounted for 73.2% of the total drug costs.Conclusions:Antibiotics are commonly prescribed to most ICU patients at admission and contribute significantly to the total drug costs. Antibiotic restriction policies and a multidisciplinary effort to reduce usage are urgently required.

Study of antimicrobial prescribing pattern in a tertiary care teaching hospital at Dehradun, Uttarakhand, India - A tool to teach clinical pharmacology to MBBS students

“…This was comparable with previous studies. 10,11 The reason for more male admissions in our study may be that female patients are reluctant to utilize health care facilities unless they are critically ill. Majority of the patients belonged to 16-30 year age group.…”

Drug utilisation in medical intensive care unit: a retrospective analysis from a tertiary care teaching hospital

“…[3][4][5] The most common indication for admission was noncardiac causes and not septicemia, in contrast to other studies. 3,5 The variability in the mean age and indication might be due to presence of separate coronary care unit and other intensive care units like SICU in the hospital.…”

Drug Utilization Pattern in an Intensive Care Unit at a Tertiary Care Teaching Hospital in Oman

“…Since patients admitted to the ICU receive multiple drugs, the majority of these drugs are empirically prescribed and mainly based on physician previous experience resulting in the lack of quantitative precision of drugs usage [6]. For example, some European reviews have indicated that over 50% of all neonatal ICU patients received off-label or an unlicensed prescription [7].…”