Related Experiment Video

Updated: Jan 13, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

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Analysis of Defined Daily Dose (DDD) and antibiotic problems in Intensive Care Unit (ICU) patients

Yulistiani Yulistiani1,2, Hargus Haraudi Barkah2, Febriansyah Nur Utomo2

  • 1Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia.

Exploratory Research in Clinical and Social Pharmacy
|January 6, 2026
PubMed

Insights

Antimicrobial resistance in ICUs necessitates evaluating antibiotic use with Defined Daily Doses (DDD) and Drug Related Problems (DRP) analysis to improve Antimicrobial Stewardship (AMS). High ceftriaxone use and DRPs highlight the need for better AMS programs.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pharmacoeconomics

Background:

  • Antimicrobial resistance (AMR) in Intensive Care Units (ICUs) presents a major hurdle for effective infection control.
  • Quantitative assessment of antibiotic consumption via Defined Daily Dose (DDD) and Drug Related Problems (DRP) analysis is crucial for Antimicrobial Stewardship (AMS) programs.

Purpose of the Study:

  • To analyze the quantitative antibiotic use in ICU patients using the DDD method.
  • To identify Drug Related Problems (DRPs) in ICU patients to support AMS programs.

Main Methods:

  • Retrospective cross-sectional study of ICU patient medical records (July-December 2022).
  • Antibiotic consumption calculated using DDD per 100 patient-days (WHO standards).
  • DRPs identified using Cipolle and Pharmaceutical Care Network Europe (PCNE) v9.1 classifications.

Main Results:

  • Total antibiotic consumption was 91.54 DDD/100 patient-days; ceftriaxone was highest at 31.57 DDD/100 patient-days.
  • Pneumonia (40%) and sepsis (25%) were predominant conditions.
  • Most frequent DRPs included unnecessary drug therapy (20%) and suboptimal therapeutic effects (23%), often due to inappropriate indications or guideline deviations.

Conclusions:

  • High antibiotic use, dominated by ceftriaxone, and frequent DRPs in the ICU underscore the need for enhanced AMS.
  • Optimizing antibiotic use requires interdisciplinary collaboration, regular audits, and adherence to clinical guidelines to mitigate AMR risks.
Keywords:
AntibioticDRPsDefined daily doseIntensive care unitResistance

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