Antibiotic Stewardship Practices and Prescribing Patterns Across Indian PICUs

Area of Science:

• Pediatric critical care medicine
• Infectious diseases
• Antimicrobial stewardship

Background:

• Antibiotic resistance is a growing global concern, particularly in intensive care settings.
• Understanding current antibiotic prescribing practices is crucial for developing effective antimicrobial stewardship programs.
• Pediatric Intensive Care Units (PICUs) face unique challenges in managing infections due to vulnerable patient populations.

Purpose of the Study:

• To investigate antibiotic prescribing patterns in Indian PICUs.
• To evaluate the characteristics of antibiotic stewardship programs in these units.
• To identify variations in antibiotic use and identify areas for improvement.

Main Methods:

• A web-based questionnaire was distributed to pediatric intensivists across India.
• Data were collected from 62 participating PICUs regarding infection types, antibiotic choices, and stewardship program attributes.
• Descriptive statistics were used to analyze prescribing patterns and program implementation.

Main Results:

• Community-acquired pneumonia was the most frequent reason for PICU admission requiring antibiotics.
• Beta-lactam monotherapy was common for community-acquired infections, while combination therapy was more frequent for hospital-acquired infections like CLABSI and VAP.
• While most PICUs have antibiotic stewardship programs (67.7%), only a minority reported formulary restrictions (45.1%) or pre-authorization policies (16.1%).

Conclusions:

• Significant diversity exists in antibiotic prescribing and administration practices across Indian PICUs.
• Antibiotic stewardship programs are prevalent, but their implementation varies, with limited use of formulary restrictions and pre-authorization.
• Further surveillance studies are recommended to standardize antibiotic policies and optimize empiric therapy selection in Indian PICUs.