Drug utilization study of antimicrobial agents in medical intensive care unit of a tertiary care hospital

ABSTRACT

Patients admitted to the Intensive care unit receive multiple medications from a variety of pharmacological classes due to life threatening illnesses. This study was conducted to assess the patterns of antimicrobial agents and to suggest necessary modifications in prescribing practices to achieve rational therapeutic practices. The present study aims to study the prescribing patterns of drugs and rationality of antimicrobial drug use in the medical ICU of a tertiary care hospital. A prospective observational study was carried out at the 15 bedded medical ICU of St. John's Medical College Hospital, Bangalore from October 15[th] 2005 to September 15[th] 2006. The relevant data on drug prescription of each patient was collected from the inpatient case record. Drugs were classified into different groups based on WHO-ATC classification. The demographic data, disease data and the utilization of different classes of drugs as well as individual drugs were analyzed. Of the 902 patients admitted in the medical ICU during the study period, 728 [81%] consecutive patients were included for the analysis. Male to female ratio was 1.9. The mean age was 49.21 +/- 15.84 years. Sepsis 198 [27%] and acute renal failure 168 [23%] were the most common primary clinical diagnoses. Maximum number of co-morbid conditions found in a single patient was 15. The average number of drugs per patient [prescription] was 11.6 +/- 2.09. Anti-peptic ulcer drugs 709 [97.4%], antimicrobial agents 679 [93%], ionotropes 340 [46.5%] were the most commonly prescribed drugs. Cephalosporins 622 [37.3%] were the commonly prescribed antimicrobial drug class. Cefoperazone [JO 1DD12] 218 [30%] was the commonly prescribed antimicrobial drug class. A total of 228 perscriptions [31.3%] contained two antimicrobial prescription and [187] 25.7% contained 3 drugs. Cefoperazone + sulbactam [J01DD62] 224[62%] was the most common FDC noticed. A wide spectrum of disorders was noticed. Extensive poly-pharmacy and Poly-therapy of antimicrobial agents were noticed