Antimicrobial Usage Pattern in Critical Care Unit

Background: Drug utilization research was defined in 1977 as the study of the marketing, distribution, prescription, and use of drugs in a society.

Objectives: To identify the utilization pattern of antimicrobials in patients admitted to the critical care unit.

Methods: A cross-sectional, record-based observational study was done in the Critical Care Unit of a tertiary care teaching hospital. Case records of patients of all age groups admitted to the ICU over a period of six months and who received at least one antimicrobial were included. Data were collected from the Medical Records Department and analyzed for 80 patients based on inclusion criteria.

Results: Antimicrobial use was found to be more common among males and in the middle-aged and elderly population. Sepsis and septic shock were the most common indications for antimicrobial therapy, followed by lower respiratory tract infections. Diabetes mellitus and hypertension were most common associated co-morbid conditions. Evaluation of prescriptions using WHO drug utilization indicators showed that a total of 472 drugs were prescribed, of which 186 (39.4%) were antimicrobials. The average number of drugs per patient was 5.9. Among antimicrobials, 34.9% were prescribed by generic name, 88.2% were given as injections, and 92.5% were from the National List of Essential Medicines (2015). Combination antimicrobial therapy was used in most patients.

Conclusion: The findings of this study can provide useful baseline data for promoting rational antimicrobial prescribing and strengthening antimicrobial stewardship practices in critical care settings.