Abstract

Objective: The objective of this study is to evaluate the trends in prescribing pattern in medical ICU concerning patient age, gender, past, and current illness along with comorbidities for the evasion of polypharmacy and to improve patient outcomes. Methods: A prospective analysis of the case records of patients admitted to the ICU of Yashoda hospital in India was carried out. Results: 120 patients were evaluated, consisting of 77% male patients. The mean±SD of age is 53.81±14.63. The majority of the study subjects belonged to the age group of 50-67 y (32%) Most common causes for admission to the ICU were Respiratory diseases and Stroke. Diabetes mellitus and Hypertension are the most common co-morbidities identified. The total number of drugs used were 1502 during this study period. The average number of drugs per prescription is 12. The range is between 2-30. The average number of antibiotics per prescription is 3. Commonly prescribed drug classes were the GI agents in 100% of patients, followed by antimicrobial agents (AMAs) in 95.8% of patients. About 42.5% of patients received 3 antibiotics per day. 55 potential drug-drug interactions were interpreted in 46 patients. 30(55%) were moderate interactions 25(45%) were major interactions, which were addressed. De-escalation of antibiotics was seen in 29% of patients while escalation in 13%. The death rate is only 5% in our ICU setting. Conclusion: This prescription pattern study can provide a framework for continuous prescription audit in the ICU

Highlights

  • MATERIALS AND METHODSThe Intensive Care antimicrobial agents (AMAs)–Anti-microbial agents (Unit) is a setting where a large number of drugs are administered to most of the patients due to their critical illness and multiple complexities [1]

  • The medical ICUs represent an important platform for conducting prescription pattern studies as they explain the extent and profile of drug use, trends, and impact on patient outcomes [2]

  • Analyses of prescription patterns will help in the evasion of polypharmacy and improve patient outcomes

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Summary

Results

120 patients were evaluated, consisting of 77% male patients. The majority of the study subjects belonged to the age group of 50-67 y (32%) Most common causes for admission to the ICU were Respiratory diseases and Stroke. The total number of drugs used were 1502 during this study period. The average number of drugs per prescription is 12. The average number of antibiotics per prescription is 3. Prescribed drug classes were the GI agents in 100% of patients, followed by antimicrobial agents (AMAs) in 95.8% of patients. About 42.5% of patients received 3 antibiotics per day. 55 potential drug-drug interactions were interpreted in 46 patients. De-escalation of antibiotics was seen in 29% of patients while escalation in 13%. The death rate is only 5% in our ICU setting

MATERIALS AND METHODS
Study design and data collection
RESULTS
DISCUSSION
CONCLUSION

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