A Prospective Observational Study to Assess the Prescription Pattern of Antibiotics in Intensive Care Unit at Tertiary Care Hospital

Abstract

Aims: The aim of the study is to assess antibiotic utilization patterns among critically ill and post-operative ICU patients, with the goals of optimizing prescribing practices, evaluating adherence to guidelines, and minimizing risks associated with antibiotic resistance. Study Design: Prospective Observational. Place and Duration of Study: BAPS Pramukh Swami Hospital, Surat between November 2022-March 2023. Materials and Methods: The study included 108 patients directly admitted to the ICU, selected based on specific inclusion criteria. Eligible patients were aged 18 years or older and categorized as critically ill or post-operative patients requiring ICU admission. Additionally, patients needed to have been prescribed at least one antibiotic, whether for prophylactic or therapeutic purposes. Detailed demographic and clinical data were recorded for each patient using a pre-established case report form. The study aimed to analyze adverse events associated with antibiotic usage among these ICU patients, utilizing Microsoft Excel for data analysis. Results: The total number of prescribed antibiotics was 235, the empirically prescribed antibiotics were Cefoperazone + Sulbactam 54 (21%) followed by Ceftriaxone (14%) and Meropenem (12%). The multiple therapy was prescribed in 63 (58%) patients. The most utilized were from WHO Watch Class 163 (69%). The value obtained for the average number of antibiotics per encounter was 2.15 (WHO optimal value: 1.6 – 1.8). The adverse events associated with antibiotics were observed in 16 patients. A culture sensitivity test was performed in 28.7% of patients. The most common pathogen detected was E.coli and K. pneumoniae. Conclusion: The study reflects the requirement of antimicrobial stewardship practice, which should focus on promoting rational antibiotic prescription, which will help in combat with critical resistance issues in the future