Prescribing pattern of antimicrobial agents in the pediatric intensive care unit of a tertiary care teaching hospital in puducherry union territory.

Drug Utilization Research and Predictors of Outcomes in the Intensive Care Unit of a Tertiary Care Hospital: A Prospective Observational Study

“…An overuse of pantoprazole (97% of patients) was observed, a finding in agreement with earlier studies [ 11 , 13 - 21 ]. Proton pump inhibitors reduce stomach acid output, inhibit upper gastrointestinal hemorrhage, and enhance mucosal healing.…”

“…In view of critical illnesses, a long period of stay in ICU, multiple organ dysfunction, and unconscious status, patients admitted to ICU are 5 to 10 times more vulnerable to nosocomial or healthcare-associated infections (HAIs) compared to those in general wards [26] which were reported to affect about 30 percent of ICU patients [5], a fact partly justifying the higher use of antibiotics in ICU settings. Seventy-nine percent of our study population received more than one antibiotic agent, a finding in agreement with similar studies from India and other developing countries [7][8][9]11,[17][18][19][20][21][22]. This is, however, in contrast to data from ICUs in Western countries reporting a relatively lesser proportion of patients being prescribed multiple antibiotic agents [11,27,28].…”

“…Due to the wide spectrum of action, favorable safety profile across different age groups, and cost, this group of antibiotics is particularly preferable in ICU patients who are prone to multiple infections due to indwelling devices. In fact, third-generation cephalosporins were the most frequently prescribed antibiotics in various other similar studies [7,9,11,[13][14][15][16][17][18][19][20][21]].…”

“…Polypharmacy (five or more drugs prescribed) was observed (99%) which was in line with some earlier studies from India [ 17 - 20 ]. Panamanian et al, however, reported only 57% incidence of polypharmacy [ 21 ]. Management of critically ill patients demands aggressive prophylactic and therapeutic measures.…”

Treatment Cost Along With Pattern of Disease and Therapy in the Intensive Care Unit of a Tertiary Care Teaching Hospital in India

“…This ‘polypharmacy’ is justified in the ICU setup of a tertiary care facility equipped to handle patients with severe illnesses, numerous co-morbidities, or challenging or non-responsive conditions. However, this was relatively less compared to many studies such as the ones conducted by Pandiamunian et al (10.4±2 drugs) [ 17 ] and Smythe et al (12±7.6 drugs) [ 18 ], while being slighter higher than that by Inan et al (eight drugs) [ 16 ] and Shobha et al (6.9 drugs) [ 13 ]. This is a positive indicator suggesting that overprescribing is perhaps not prevalent in our setting.…”