Yoğun Bakım Hastalarında Antimikrobiyal İlaç Dozajlarının Uygunluğunun Değerlendirilmesi

Abstract

The purpose of this study was to investigate the factors that required dose adjustments of antimicrobial drugs in intensive care unit (ICU) patients and to identify the drugs that required the most dose adjustments.
 The 26-bed reanimation ICU of a university-affiliated hospital hosted this study from September to December 2022. Two clinical pharmacists on duty examined patients' antimicrobial drug dosages daily. The acceptance status of the recommendations and the patients' demographic information were recorded.
 The study involved 133 ICU patients, and antimicrobial drug recommendations were made for 48 patients, 31 (64.6%) of whom were male. The median (IQR) age of the 48 patients was 67 (54–77). The number of recommendations was 94, and all of them were accepted by the physician. The recommendation rates according to the causes were: inappropriate dosages based on renal functions (71.3%), presence of continuous renal replacement therapy (11.7%), indication (10.6%), body weight (4.3%), and loading dose (2.1%).
 The top 3 drugs for which recommendations were made the most were colistin (21.3%), meropenem (18.1%), and piperacillin-tazobactam (12.8%). The most troublesome drug was colistin, which is frequently used to treat Acinetobacter pneumonia. Clinical pharmacist and physician collaboration may help rationalize ICU antimicrobial drug use.