Antibiotic usage in an intensive care unit in a Danish university hospital

Abstract

We report a study of antimicrobial use in patients admitted to the Intensive Care Unit (ICU) in a Danish university hospital during the course of 1 year. Of 615 patients admitted, 434 (71%) received antibiotics, 220 (36%) for infections and 222 (36%) for prophylaxis. Therapy for suspected infection accounted for 67% of the total consumption of antibiotics and prophylaxis for 33%. Ampicillin was the drug most frequently used; 43% of the patients treated for infection received this drug. One hundred and thirty-one patients (60%) were treated for suspected lower respiratory tract infection. Relevant microbiological specimens were obtained from 120 (92%) of these patients and a possible pathogen was isolated in 92 patients (77%, 92/120). Staphylococcus aureus and Streptococcus pneumoniae were each isolated in almost a quarter of the patients, and Enterobacteriaceae in 53%. However, many of the pathogens isolated were of no clinical relevance and merely reflected a state of colonization. Most treatments were given during the first few days following admission. Of 220 patients receiving antibiotics for an infection, 87% were treated on day 1, but only 34% (14 of 41) on day 11. The frequent use of laboratory investigations combined with good communication between clinicians and microbiologists probably resulted in rapid cessation of unnecessary therapy. Fifty-two per cent of the antibiotics given for prophylaxis were administered later than the first postoperative day. This study emphasizes the need for consultation between surgeons and clinical microbiologists to supervise postoperative antibiotic use.

Antibiotic Usage in Intensive Care Units of Tabriz Imam Reza Hospital, 2011

“…Studies show that over 70% of ICU patients receive antibiotics. Despite the important role of antibiotics in treating the infections, they are involved in the antibiotic resistances due to empirical usage of antibiotics in mentioned hospital wards (Kolle, 2001;Krivoy et al, 2002;Roder et al, 1993;Rice, 2003).…”

“…The studies that have been conducted over the past decades had proven varying degrees of incorrect use of antibiotics (Roder et al, 1993). Increasing emergence of antibiotic resistance and threats the recovery of patients while increasing the overall cost of health care costs (Rello, 2007).…”

Influence of an Infectious Disease Service on Antibiotic Prescription Behavior and Selection of Multiresistant Pathogens

“…In intensive care units (ICU), in particular, physicians tend to use broad-spectrum antibiotics indiscriminately [2]. The development of bacterial resistance to antibiotics correlates with antimicrobial use, and preventing resistance clearly requires optimization of antibiotic treatment [3][4][5].…”

Prevention of ventilator-associated pneumonia

“…VAP prolongs the duration of mechanical ventilation, increases lengths of stay in the intensive care unit (ICU) and extends hospitalizations [8,9]. Treatment of suspected and confirmed VAP is estimated to account for approximately 50% of antibiotic dispensing in ICUs [10][11][12]. These factors make VAP a potent driver of morbidity, cost and the cultivation of antibiotic-resistant bacteria.…”