Analysis of Antimicrobial Prescribing Patterns and Resistance Trends in Intensive Care Units

Antimicrobial resistance (AMR) is an increasing health issue worldwide with the intensive care unit (ICU) being the main place where the phenomenon has become common due to the high use of antibiotics. The purpose of the research was to study the pattern of antimicrobial prescribing and resistance of patients admitted at ICU in a tertiary care hospital.

The case of a prospective observational study was carried out during 12 months with 200 patients in the ICU who received antimicrobial therapy. Demographic, antimicrobial prescription, indications, and microbiological culture report data were gathered and compared. Descriptive statistics were represented as mean, standard deviation, and percentages, and Chi-square and t-tests were used in the inferential analysis.

The average age of patients was 54.6 years, and there were 62 males. The empirical antibiotic treatment was started in 78% of the cases with the most common ones (42% and 36%, respectively) being carbapenems and piperacillin-tazobactam. Only 28% cases showed de-escalation that was culture sensitive. Isolates with multidrug-resistance were found in 39% with the most common being Acinetobacter baumannii (18) and Klebsiella pneumoniae (15). Carbapenems resistance was observed in 32% of the isolates. There was a considerable difference in mortality (34 vs. 18, P = 0.02) between patients who received inappropriate empirical therapy.

The research paper indicates the common occurrence of empirical broad-spectrum antibiotic use and high resistance patterns in the ICU. Antimicrobial stewardship programs and following culture-directed therapy should be implemented to limit the increasing antimicrobial resistance.