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Updated: Oct 18, 2025
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Antimicrobial consumption in intensive care unit patients at level 1 trauma centre in India
Parul Singh1, Deepak Kumar Gupta2, Ashish Bindra3
1Department of Microbiology, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
Purpose:
Increase in the antimicrobial resistance causes a concern globally. To mitigate the rapidly rising antimicrobial resistance in the health system globally antimicrobial stewardship programs (AMSP) have been advocated. Therefore, we aim to measure aggregate antibiotic consumption by both Defined Daily Dosage (DDD) and Days of Therapy (DOT) methods.
Methods:
As a part of Indian Council of Medical Research initiative to develop local AMSP, this prospective study of six months was conducted at a level -1 Trauma Centre of AIIMS, New Delhi. In this, we have included all the patients of polytrauma and neurosurgical Intensive care units between April to October 2019. Consumption of antibiotics data were collected manually daily by infection control practitioners. Data were presented as Days of Therapy (DOT) and Defined Daily Dose (DDD).
Results:
During the six months of study, antimicrobial consumption of ICU was compared with empirical therapy v/s culture-based therapy. Overall average antimicrobial consumption for the six months for both empirical therapy and culture-based therapy DDD/1000 patient days was 531.8 and 460.7 whereas DOT/1000 patient days 489.9 and 426.04 respectively.
Conclusions:
Antimicrobial Stewardship activities aim to ensure judicious consumption of antimicrobials. Such data will be of value in establishing, evaluating and monitoring the function of the AMSP in the healthcare settings.
Insights
This study measured antibiotic consumption in an intensive care unit using Defined Daily Dosage (DDD) and Days of Therapy (DOT) methods. Findings will help establish and monitor antimicrobial stewardship programs (AMSP) to combat rising antimicrobial resistance.
Area of Science:
- Medical Research
- Infectious Diseases
- Public Health
Background:
- Rising antimicrobial resistance is a global health concern.
- Antimicrobial stewardship programs (AMSP) are crucial for mitigating resistance.
- Accurate measurement of antibiotic consumption is essential for effective AMSPs.
Purpose of the Study:
- To measure aggregate antibiotic consumption in an intensive care unit (ICU).
- To utilize Defined Daily Dosage (DDD) and Days of Therapy (DOT) methods for consumption assessment.
- To provide data for establishing and evaluating local AMSPs.
Main Methods:
- Prospective study conducted over six months (April-October 2019) at a level-1 Trauma Centre.
- Included patients from polytrauma and neurosurgical ICUs.
- Antibiotic consumption data collected daily by infection control practitioners and analyzed using DDD and DOT.
Main Results:
- Overall average antimicrobial consumption: 531.8 DDD/1000 patient days for empirical therapy and 460.7 DDD/1000 patient days for culture-based therapy.
- Overall average antimicrobial consumption: 489.9 DOT/1000 patient days for empirical therapy and 426.04 DOT/1000 patient days for culture-based therapy.
- Comparison between empirical and culture-based therapy consumption patterns was performed.
Conclusions:
- Antimicrobial Stewardship activities are vital for judicious antimicrobial use.
- Collected data are valuable for establishing, evaluating, and monitoring AMSP effectiveness.
- This study provides baseline data for antimicrobial consumption in a critical care setting.
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