Prescription pattern, safety and prevalence of resistance of antimicrobial drugs in MICU of IGIMS, Patna: An observational and prospective study

Saajid Hameed,Hitesh Mishra,Lalit Mohan,Shambhu Kumar Yadav,Manish Kumar

doi:10.18231/j.ijcaap.2019.023

Saajid Hameed, Hitesh Mishra + Show 3 more

Open Access

https://doi.org/10.18231/j.ijcaap.2019.023

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Abstract

Objective: Due to limited availability of newer antibiotics to treat emerging multidrug-resistant species of pathogen, there is an urgent need for highlighting the misuse of antibiotics and taking appropriate measures to promote rational antibiotic prescription. This study was designed to know the antibiotic prescription patterns in MICU, the prevalence of antibiotic resistance, the effectiveness of empirical antibiotic therapy and safety and tolerability of the antibiotics prescribed. Materials and Methods: This study was an observational and prospective study. 100 consecutive prescriptions were collected from MICU, IGIMS, Patna from January 2019 to June 2019. All antibiotics listed on first prescription slip was noted and their dosage schedule, route of administration, date of discontinuation, generic name and related laboratory investigations were also recorded. Result: 723 drugs were prescribed out of which 244 were antibiotics. 3rd generation cephalosporins (118 prescription/48.36 %) were most frequently prescribed followed by Amoxicillin + Clavulanate (40 prescriptions/16.39%). Prevalence of resistance was most in cephalosporins (6%) followed by Amoxicillin + Clavulanate (5%). Approx. 27.5% failure of treatment was found in patients receiving empirical antibiotic therapy. Percentage of suspected ADRs was mostly found in linezolid (33.33%) followed by Ceftriaxone (16.66%). Conclusion: Antibiotics are overprescribed in our ICUs and this is increasing the burden of unnecessary adverse effect, resistance and treatment costs. At the time of admission, patients with poor prognosis and older age are prescribed more antibiotics. Antibiotics stewardship programs should be promoted and regulation of antibiotic utilization, proper use of guidelines and proper surveillance should be ensured by responsible authorities. Keywords: Antibiotics, ICU, Prescriptions, Resistance, Safety & tolerability.

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