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Drug Utilization Evaluation of Higher End Antibiotics inan Intensive Medical Care Unit ofa Tertiary Care Hospital
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| Author:
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JENI SHARON, BONISH ROMANCE, LAKSHMI S, JASNOSAJI JOHN, BABUN, AARTHIPRAKASAM, S.RAMALAKSHMI
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| Abstract:
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Intensive care unit (ICU) requires emergent coverage with empirical broad-spectrum antibiotics, with a
subsequentde-escalation based on culture report. Antimicrobial resistance has emerged as an important determinant
of outcome for patients in the intensive care unit. Hence, the present study was aimed to evaluate the prescriptions
with higher end antibiotics among critically ill patients. This was aprospective cross sectional observational study
conducted in the Intensive Medical Care Unit of a tertiary care hospital in Chennai for a period of 6months. The data
of patients prescribed with the selected higher end was collected using a pre-structured data entry form.
Theantibiotics prescribed were analysed for appropriateness based on several criteria with the Hospital antibiotic
policy.A total of 271 high end antibiotics were prescribed for 160 patients of which PiperacillinTazobactam (33.5%)
and Meropenem (30.6%) were predominant. About 70.11% were on empiric therapy and 29.8% were on definitive
therapy based on culture test. The most prevailing organism was found to beEscherichiacoli(35.8%). There was an
increase in resistance to PiperacillinTazobactamtowardsEscherichiacoli (39.4%), Klebsiella pneumonia (55%) and
Acinetobacterbaumannii(71.4%). Prescription analyses indicate, 18.45 % of inappropriateness. The main reason for
inappropriateness was with respect to dosage adjustment (11 %), dosing interval (9.22 %) anddose (7.38%).There was
a satisfactory standard has maintained inthe hospital. However, dosing adjustment in renalpatient need further
intervention to improve the quality of health care
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| Keyword:
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Drug Utilisation Evaluation, Antimicrobial Resistance, Restricted Antibiotic
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2019.11.03.022
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| Download:
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