Antibiotics Use Patterns in Intensive Care Units of Five Hospitals in Tehran During 2011 - 2012

Abstract

Background: Inappropriate use of antibiotics is one the most important challenges for health systems. In the hospital setting, intensive care unit (ICU) is a unique place in generating antibiotic-resistant pathogens. Irrational use of antibiotics is one of the main reasons of increasing the resistance of pathogens. Objectives: In this study, we aimed to evaluate antibiotics use pattern in ICUs of five hospitals in Tehran, Iran. Materials and Methods: This observational cross-sectional research aimed to evaluate antibiotic use patterns in ICUs of five hospitals in Tehran, Iran. Retrospectively, data related to antibiotic consumption in ICUs of five Military General Hospitals were collected from 20 March 2011 to 20 March 2012. The Anatomical Therapeutic Chemical classification system and the Defined Daily Dose used to evaluate consumption of antibiotics and drug use 90% was determined for all ICUs antibiotic consumption. Data was analyzed by SPSS software version 16 using one way ANOVA and Tukey post hoc tests to compare antibiotic consumption in ICUs between different hospitals. Results: Antibiotic use in ICU2 ward of hospital C was significantly higher than hospitals A, D, E and ICU-Open Heart (ICUOH) of hospital C (P value ≤ 0.001). Use of antibiotic in ICU1 ward of hospital C was also higher significantly compared to hospitals D, E and ICUOH of hospital C (P value ≤ 0.001). Drug use 90% profile of hospitals’ ICUs showed that Beta-lactams, Cephalosporin and Vancomycin were the most antibiotics used in these wards. Conclusions: Use of antibiotics was higher than expected in the studied ICU wards and the antibiotics use pattern was different from other countries. This problem should be addressed to correct the use pattern of antibiotics in ICUs. Implementation of antibiotic use and microbial resistance monitoring programs, continuous medical education for physicians and compilation of clinical practice guidelines and protocols could be effective in reduction of antibiotic use in hospitals.