Evaluation of Antimicrobial use in Ventilated Patients in Coronary Care Unit of a Tertiary Care Hospital

Abstract

In developing countries, excess and indiscriminate use of antibiotics in community and hospital settings can lead to adverse effects primary to prolongation of therapy, harbour antibiotic resistance bacteria, rise in health expenditures and decrease quality of life. Antimicrobial resistance in the intensive care unit (ICU) has emerged as an important problem in this scenario. Recent studies revealed that antibiotic use is roughly ten times larger in ICU than in general wards. Research studies are required to gain suitable information concerning the use of antimicrobials (AMA) in ventilated patients which helps in improving the prescribing pattern of antimicrobial and also in executing infection control strategies in the therapy modification of such patients. There is barely limited data on antibiotic prescribing pattern in ventilated patients from India hence this study was carried out with an objective to know more about the antibiotic prescribing pattern and to analyze rationality among the prescriptions. This retrospective study was conducted in the Coronary care unit (CCU) of tertiary care hospital in South India from June 2014 to December 2014. The prescribing pattern of antimicrobials in patients aged between 10-90 years was studied. Total 33 AMA preparations were used either single or in combination. In the study, the commonly used AMAs were beta-lactam antibiotics, particularly ceftriaxone, levofloxacin followed by piperacillin + tazobactam (extended –spectrum penicillins + s-lactamase inhibitor) as single or combination therapy. Combination of AMAs was used in 54.3% of patients. In order to achieve good outcome right use of antibiotic at right time and right dose is required, based on general AMAs prescribing pattern and susceptibility pattern of pathogens, which aid to minimize the irrational employ of antibiotics and extra pressure for resistance.