A STUDY EVALUATING APPROPRIATENESS OF UTILIZATION PATTERN OF ANTIMICROBIALS IN PATIENTS ADMITTED IN MEDICAL INTENSIVE CARE UNIT OF TERTIARY CARE TEACHING RURAL HOSPITAL


Ravi R Alamchandani, Pooja R Khubchandani

Abstract


Objectives: To evaluate the appropriateness of utilization pattern of antimicrobials in the intensive care unit of a tertiary care teaching rural hospital.

Methods: This prospective and observational study was carried out in 500 patients admitted to the intensive care unit (ICU) who was prescribed antimicrobial agents, between October 2011 and May 2013. All patients were followed up throughout their stay. A study was carried out to study the appropriateness of utilization pattern of antimicrobials in the medical ICU.

Results: The dosage form of the prescribed antimicrobial was most appropriate. Most common route of drug administration was intravenous and it was most appropriate. Dose of drugs chosen was acceptable and the frequency of administration of antimicrobials was also acceptable. However, in 47 patients change of antimicrobials following initial empirical therapy was done without CST which was inappropriate. The appropriateness score calculated using structured, semi scientific, arbitrary 20 point appropriateness scale, was 15.48. The score, 15.48, fell in the category of appropriate use and the use of antimicrobials was found to be appropriate.

Conclusion: To prevent antimicrobial resistance, rational use of antimicrobials is a must. The concept of prescribing antimicrobial drugs for every patient should be abolished. Antimicrobial policy should be developed and it must be ensured that it is implemented. Antimicrobial stewardship should also be implemented to prevent the emergence of resistance.


 


Keywords


Antimicrobials, Utilization pattern of antimicorbials, Intensive care unit, Rationale for use of antimicrobial

| PDF | HTML |

References


Leibovitz A, Dan M, Zinger J, Carmeli Y, Habot B, Segal R. Study of device associated nosocomial infections in ICU patients. Chest 2001;119(2):305-11.

Fridkin SK, Steward CD, Edwards JR, Pryor ER, McGowan JE Jr, Archibald LK, et al. Surveillance of antimicrobial use and antimicrobial resistance in United States hospitals: project ICARE phase 2. Project intensive care antimicrobial resistance epidemiology (ICARE) hospitals. Clin Infect Dis 1999;29(2):245-52.

Park K. Infectious disease epidemiology. Park’s textbook of preventive and social medicine. 18th ed. Jabalpur: Bhanot Publishers; 2005. p. 47-108.

Wilson WR, Karchmer AW, Dajani AS, Taubert KA, Bayer A, Kaye D, et al. Antibiotic treatment of adults with infective endocarditis due to streptococci, enterococci, staphylococci, and HACEK microorganisms. American Heart Association. JAMA 1995;274(21):1706-13.

Wenzel RP, Thompson RL, Landry SM, Russell BS, Miller PJ, Ponce de Leon S, et al. Hospital acquired infections in intensive care unit patients: an overview with emphasis on epidemics. Infect Control 1983;4(5):371-5.

World Health Organization [Internet]. Rational use of medicines. In: The world medicines situation. 2004. p. 75-91.

Akinyandenu O, Akinyandenu A. Irrational use and non-prescription sale of antibiotics in Nigeria: A need for change. J Sci Innovative Res 2014;3(2):251-7.

Gaash B. Irrational use of antibiotics. Indian J Practicing Doctor 2008;5(1):25-9.

World Health Organization [Internet]. Interventions and strategies to improve the use of antimicrobials in developing countries: a review. c2001 [cited 2013 Sept 25]. Available from: http://www. who. int/drugresistance/Interventions_ and_strategies_to_improve_the_use_of_antim. pdf.‎

World Health Organization. Introduction to drug utilization research. c2003 [cited 2013 Sept 25]. Available from: http://apps. who. int/medicinedocs/en/d/Js4876e.‎

World Health Organization. Model List of Essential Medicines for adult 18th List. c2013 [cited 2013 Sept 25]. Available from http://www. who. int/medicines/publications/ essentialmedicines/en/index. html.‎

World Health Organization. Prevention of hospital-acquired infections. c2002 [cited 2013 Sept 25]. Available from: http: //www. who. int/csr/resources/publications/whocdscsreph 200212. pdf.

Raveh D, Levy Y, Schlesinger Y, Greenberg A, Rudensky B, Yinnon AM. Longitudinal surveillance of antibiotic use in the hospital. QJM. 2001;94(3):141-52.

Buxton IL. Pharmacokinetics and pharmacodynamics: the dynamics of drug absorption, distribution, action, and elimination. In: Brunton LL, Lazo JS, Parker KL, editors. Goodman & Gillman’s the pharmacological basis of therapeutics. 12th ed. New Delhi: The McGraw-Hill Companies; 2011. p. 17-41.

Nicolle LE, Bentley D, Garibaldi R, Neuhaus E, Smith P. antimicrobial use in long-term-care facilities. Infect Control Hosp Epidemiol. 1996;17(2):119-28.

Harbarth S, Garbino J, Pugin J, Romand JA, Lew D, Pittet D. Inappropriate initial antimicrobial therapy and its effect on survival in a clinical trial of immunomodulating therapy for severe sepsis. Am J Med 2003;115(7):529–35.




About this article

Title

A STUDY EVALUATING APPROPRIATENESS OF UTILIZATION PATTERN OF ANTIMICROBIALS IN PATIENTS ADMITTED IN MEDICAL INTENSIVE CARE UNIT OF TERTIARY CARE TEACHING RURAL HOSPITAL

Keywords

Antimicrobials, Utilization pattern of antimicorbials, Intensive care unit, Rationale for use of antimicrobial

Date

12-03-2015

Additional Links

Manuscript Submission

Journal

International Journal of Pharmacy and Pharmaceutical Sciences
Vol 7, Issue 5, 2015 Page: 101-104

Online ISSN

0975-1491

Statistics

111 Views | 57 Downloads

Authors & Affiliations

Ravi R Alamchandani
Department of Pharmacology, S. B. K. S. Medical Institute and Research Centre, Sumandeep Vidyapeeth, Piparia, Vadodara-391760, Gujarat, India
India

Pooja R Khubchandani
Dept of Periodontics, Manubhai Patel Dental College, Vishwajyoti Ashram, Nr. Vidyakunj School, Munjmahuda, Vadodara-390011, Gujarat, India
India


Article Tools



Refbacks

  • There are currently no refbacks.