Utilisation of antimicrobial agents in intensive care unit at a tertiary care teaching hospital in eastern India

Abstract

Background: Antimicrobial agents (AMAs) are the most frequently used drugs in the intensive care units (ICU) and regular auditing can prevent the development of resistance to AMAs, reduce the cost and incidence of adverse drug reactions. The present study was conducted to assess the drug utilisation pattern by measuring the defined daily dose (DDD) per 100 bed days for the AMAs used and their correlation with the APACHE score II.Methods: This was a prospective observational study, conducted in the Central ICU of SCB Medical College and Hospital, Cuttack, Odisha for 4 months. Data regarding demographic profile, diagnosis, APACHE II score, microbiologic investigation, length of stay, outcome and utilisation pattern of AMAs assessing anatomic therapeutic chemical (ATC) classification and measuring the antimicrobial consumption index (ACI) equal to DDD per 100 bed days were collected and subjected to descriptive analysis. Multinomial logistic regression model was used to predict probabilities of different possible outcomes of categorically distributed variables and independent variables.Results: Mean age of study population was 44.70±14.814 with male and female ratio of 1.63:1. Septicaemia was the most common cause of admission. AMAs were prescribed to 92.66% of patients during their stay which constitutes 37.32% of the total drugs used. The DDD per 100 bed days for the AMAs were 118.59 and ceftriaxone was found to be most frequently used. Patients having higher APACHE II score received more no of AMAs (4.20±1.30). Patients having low APACHE II Scores received less number of antibiotics as compared to patients having higher score.Conclusions: AMAs were prescribed to 92.66% patients in the central ICU and there is significant relation between the APACHE II score and number of AMAs prescribed.

Influence of reserve antimicrobial indent form in antimicrobial utilization pattern in intensive care unit of tertiary care hospital in North India

“…The mean age of patients in MRD group was 56.16 and in ICU group was 56.00 years. It has been found an earlier study conducted by Kumar S et al that mean age of patients was 66.84 years which also correlates with similar study [16][17]. The consumption of amoxicillin /clavulanic and piperacillin /tazobactum was 242.86 and 204.76 DDD/100 bed days in MRD group and, consumption of meropenem and piperacillin/tazobactum was 177.78 and 176.19 DDD/100 bed days in ICU group, However a study conducted by Suraj et al found out consumption metronidazole and piperacillin/tazobactum 35.32 and 23.82 DDD/100 bed days which is lower than compared to our study, this could be explained by the fact the empirical prescription habits in ICU with possible increase in pneumonia patients with COVID 19 positive infection.…”

Study of Antimicrobial Utilization and Cost of Therapy in Medicine Intensive Care Unit of a Tertiary Care Hospital in Eastern India

“…The median APACHE II and SOFA score in restricted antibiotics were 20 (16–25) and 7 (5–10), compared to score in non-restricted antibiotics were 17 (12–21) and 5 (3–7), respectively ( Table 4 ). In support of these findings while reviewing other Indian studies, it was found that there was significant association between APACHE II and numbers of AMAs used, 12 , 13 but limited study available in the database to find the association between APACHE II and SOFA with use of restricted antibiotics.…”

“…APACHE II and SOFA are the prognostic scoring system calculated within 24 hours of admission to ICU which can be used to predict mortality. 13 In this study, it was found that on increasing SOFA and APACHE II score the use of restricted antibiotics also increased. The median APACHE II and SOFA score in restricted antibiotics were 20 (16–25) and 7 (5–10), compared to score in non-restricted antibiotics were 17 (12–21) and 5 (3–7), respectively ( Table 4 ).…”

Effect of educational session on antimicrobial consumption pattern in the medical intensive care unit of government tertiary care hospital, Jaipur, Rajasthan

“…It has been found an earlier study done by Panda et al, that mean age of study population was 44.70±14.814 with male and female ratio of 1.63:1. 10 Another study concluded that mean age of patients was around 53 years which was nearly equal for both males and females. 11 In the present study, a total of 616 antimicrobial drugs prescribed during the period of study.…”