Title: Antibacterial Prescription Pattern in Medical and Surgical Intensive Care Units of a Tertiary Care Hospital
Authors: Shahid Saache, Sujeet Divhare, Balasaheb Ghongane, Shaheen Shaikh
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.181
Abstract
Objectives: This study was conducted to assess the prescribing pattern of Antibacterial agents in Medical and Surgical ICU of a tertiary care teaching hospital in Maharashtra and to suggest necessary modifications in prescribing Antibacterial drugs to achieve rational therapeutic practices.
Materials and Methods: In this prospective observational study data of the first 1000 eligible consecutive case records of patients admitted to the Medical and Surgical ICUs during the study period of 1 year were taken. The data was then recorded in the proforma and analysed using Microsoft Excel 2013.
Results: 74.1% and 25.9% prescriptions were from Medical and Surgical ICU respectively. Majority of MICU patients were elderly more than 60 years and with involvement of cardiovascular system (41.7%). Most frequently used Antibacterial drugs in MICU and SICU was Ceftriaxone (48.3%) and Metronidazole (97.2%) respectively. Polypharmacy was observed in both. Majority of parenteral Antibacterials were prescribed in MICU (71%) and SICU (91%) and more than 95% Antibacterials were prescribed by brand names in both. 88% Antibacterials from MICU and 83% from SICU were from national list of essential medicines.
Conclusion: Most Antibacterial prescriptions were made without bacteriological culture and sensitivity testing evidences in MICU (73.8%) and SICU (42.9%).
Antibacterial prescriptions were rational with respect to WHO drug use indicators in most patients. But most of the prescriptions were not supported by culture and sensitivity reports, as it was not done in many patients of ICU. The number of Antibacterials prescribed by generic names was low in the ICU and effort must be made to encourage prescribing by generic names.
Keywords: Antibacterial prescription pattern, Intensive care units, Drug utilization studies, Antibiotics in critical care, Rational drug use.
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