Abstract
Most developing countries are adopting antibiotic policies to contain the acute problem of drug resistance; however, several obstacles prevent their fulfillment. This study was undertaken to prospectively determine the compliance with the antibiotic policy in the intensive care unit (ICU) of a tertiary care hospital and possible reasons for non-compliance. Compliance with the newly introduced antibiotic policy was studied for a period of six months. A total of 170 cases from the ICU were included. Relevant information regarding patient characteristics, treatment details, infection control, and antibiotic prescribing practices in the ICU with reference to the antibiotic policy was collected. Reasons for non-compliance were studied. The rate of compliance with the antibiotic policy was 21.18%. Heavy use of antibiotics prior to the time of admission in the ICU was the major cause of non-compliance. Microbiological investigation had been sent in only 51.17% of the cases and change in treatment protocol based on culture report was done in 53.3%. The rate of use of third-generation cephalosporins was 76.78%. We found non-compliance with the antibiotic policy in the ICU mainly due to improper and inappropriate antibiotic usage in other indoor units of the hospital. In our case, a policy covering the entire hospital is required to meet the goals of antibiotic usage restriction. An effective surveillance, review, and evaluation process should be an integral part of the policy, even in developing countries, to measure the effects of such policies.
Highlights
Most developing countries are adopting antibiotic policies to contain the acute problem of drug resistance; several obstacles prevent their fulfillment
Developed nations have provided substantial evidence showing that guidelines to control antimicrobial resistance can be effective, but these pertain to resistance trends and antibiotic usage suited to their conditions only [1].Requirements in developing countries are quite different
There have been a good number of studies about compliance with the antibiotic guidelines and assessment of antibiotic usage in various units of the hospital [4,5], but very few of these have tried to focus on the causes of non-compliance
Summary
Most developing countries are adopting antibiotic policies to contain the acute problem of drug resistance; several obstacles prevent their fulfillment. Conclusions: We found non-compliance with the antibiotic policy in the ICU mainly due to improper and inappropriate antibiotic usage in other indoor units of the hospital. Developed nations have provided substantial evidence showing that guidelines to control antimicrobial resistance can be effective, but these pertain to resistance trends and antibiotic usage suited to their conditions only [1].Requirements in developing countries are quite different. The intensive care unit is conducive to the development of antimicrobial resistance primarily because of the considerable use of antibiotics prophylactically, reducing risk of specific infections at the cost of emergence of MDRO. There have been a good number of studies about compliance with the antibiotic guidelines and assessment of antibiotic usage in various units of the hospital [4,5], but very few of these have tried to focus on the causes of non-compliance
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