Antibiotic prescription patterns at admission into a tertiary level intensive care unit in Northern India
- PMID: 22219587
- PMCID: PMC3249701
- DOI: 10.4103/0975-7406.90108
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.
Keywords: Admission; antibiotic usage; intensive care unit; prescriptions.
Conflict of interest statement
Figures
Similar articles
-
Study of Antimicrobial Utilization and Cost of Therapy in Medicine Intensive Care Unit of a Tertiary Care Hospital in Eastern India.Indian J Crit Care Med. 2020 Oct;24(10):938-942. doi: 10.5005/jp-journals-10071-23552. Indian J Crit Care Med. 2020. PMID: 33281318 Free PMC article.
-
Treatment Cost Along With Pattern of Disease and Therapy in the Intensive Care Unit of a Tertiary Care Teaching Hospital in India.Cureus. 2024 Jan 27;16(1):e53052. doi: 10.7759/cureus.53052. eCollection 2024 Jan. Cureus. 2024. PMID: 38410313 Free PMC article.
-
Antimicrobial agents' utilization and cost pattern in an Intensive Care Unit of a Teaching Hospital in South India.Indian J Crit Care Med. 2016 May;20(5):274-9. doi: 10.4103/0972-5229.182200. Indian J Crit Care Med. 2016. PMID: 27275075 Free PMC article.
-
Patterns of Antimicrobials Prescribed to Patients Admitted to a Tertiary Care Hospital: A Prescription Quality Audit.Cureus. 2021 Jun 24;13(6):e15896. doi: 10.7759/cureus.15896. eCollection 2021 Jun. Cureus. 2021. PMID: 34322343 Free PMC article.
-
Antibiotic-Drug Interactions in the Intensive Care Unit: A Literature Review.Antibiotics (Basel). 2024 May 29;13(6):503. doi: 10.3390/antibiotics13060503. Antibiotics (Basel). 2024. PMID: 38927170 Free PMC article. Review.
Cited by
-
Anaerobic antibiotic usage for pneumonia in the medical intensive care unit.Respirology. 2017 Nov;22(8):1656-1661. doi: 10.1111/resp.13111. Epub 2017 Jul 4. Respirology. 2017. PMID: 28677255 Free PMC article.
-
A study of utilization of antimicrobial agents in patients on ventilator in intensive care unit (ICU) at tertiary care teaching hospital, India.J Clin Diagn Res. 2014 Nov;8(11):HC09-13. doi: 10.7860/JCDR/2014/11184.5156. Epub 2014 Nov 20. J Clin Diagn Res. 2014. PMID: 25584243 Free PMC article.
-
Evaluation of antibiotic prescribing pattern in pediatrics in a tertiary care hospital.Avicenna J Med. 2021 Jan 5;11(1):15-19. doi: 10.4103/ajm.ajm_73_20. eCollection 2021 Jan-Mar. Avicenna J Med. 2021. PMID: 33520784 Free PMC article.
-
Study of Antimicrobial Utilization and Cost of Therapy in Medicine Intensive Care Unit of a Tertiary Care Hospital in Eastern India.Indian J Crit Care Med. 2020 Oct;24(10):938-942. doi: 10.5005/jp-journals-10071-23552. Indian J Crit Care Med. 2020. PMID: 33281318 Free PMC article.
-
Prescribing Pattern of Antibiotics Using WHO Prescribing Indicators Among Inpatients in Ethiopia: A Need for Antibiotic Stewardship Program.Infect Drug Resist. 2020 Aug 11;13:2783-2794. doi: 10.2147/IDR.S262104. eCollection 2020. Infect Drug Resist. 2020. PMID: 32884305 Free PMC article.
References
-
- Esposito S, Leone S. Antimicrobial treatment for intensive care unit (ICU) infections including the role of the infectious diseases specialist. Int J Antimicrob Agents. 2007;29:494–500. - PubMed
-
- Weber RJ, Kane SL, Oriolo VA, Saul M, Skledar SJ, Dasta JF. Impact of intensive care drug costs: A descriptive analysis, with recommendations for optimizing ICU pharmacotherapy. Crit Care Med. 2003;31:17–24. - PubMed
-
- Paterson DL, Rogers BA. How Soon Is Now? The urgent need for randomized, controlled trials evaluating treatment of multidrug-resistant bacterial infection. Clin Infect Dis. 2010;51:1245–7. - PubMed
-
- ATC index with DDDs. Oslo: WHO Collaborating Centre for Drug Statistics Methodology; 2002. WHO Collaborating Centre for Drug Statistics Methodology.
LinkOut - more resources
Full Text Sources
Research Materials