Utilization of antimicrobial agents in patients on ventilator in medical Intensive Care Unit at a tertiary care teaching hospital: A prospective study

Area of Science:

• Pharmacology
• Infectious Diseases
• Critical Care Medicine

Background:

• Bacterial infections pose a significant health burden, often exacerbated by inappropriate antimicrobial agent (AMA) use leading to antibiotic resistance.
• The continuous introduction of new antimicrobial drugs necessitates thorough studies on their utilization, effectiveness, and safety profiles.
• Understanding prescription patterns is crucial for optimizing AMA therapy, especially in vulnerable patient populations.

Purpose of the Study:

• To investigate the prescription patterns of antimicrobial agents (AMAs) in patients requiring mechanical ventilation.
• To identify trends in AMA prescribing within an intensive care unit (ICU) setting.
• To establish baseline data for rationalizing AMA utilization in ICUs.

Main Methods:

• A prospective, observational study was conducted over six months in a tertiary care hospital's Medical Intensive Care Unit (ICU).
• Prescription patterns of AMAs were systematically analyzed using a predesigned format.
• Descriptive statistics were employed to analyze the collected data.

Main Results:

• 520 ventilated patients receiving AMAs were studied; 59% received them prophylactically and 92% empirically.
• Beta-lactams combined with metronidazole were the most frequently prescribed AMAs; 73% of patients required multiple AMAs concurrently.
• AMA therapy was adjusted based on culture reports or clinical response in 9% of patients, with effective infection prevention observed in 34%.

Conclusions:

• The study provides essential baseline data on AMA prescribing in ICU patients on ventilators.
• Findings highlight the need for rationalizing AMA use in ICUs to combat antibiotic resistance.
• Further research into prescribing patterns is recommended for tertiary care units to enhance antimicrobial stewardship.