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Original Research

A prospective study on antibiotic usage and cost pattern in an intensive care unit of a tertiary care hospital

Suraj B, Somashekara S C, Sandeep B, Vaishnavi Desai, Hooli Tanuja V, Srikanth.


Background: Antibiotic resistance is on rise and has become a worldwide problem, especially in intensive care unit (ICU) patients because of higher utilization and inappropriate usage of antibiotics. Consumption of drugs can be measured by defined daily dose (DDD)/100 bed-days as recommended by the WHO. Data of antibiotic utilization can be used for developing hospital antibiotic policy.

Aims and Objectives: The current study was planned to assess the pattern of antibiotics usage from admission to discharge from the ICU and to assess the cost of antibiotic therapy.

Materials and Methods: This study was observational, prospective in nature, conducted in an ICU of a tertiary care hospital from June 2019 to August 2019. The demographic data, clinical variables, the utilization of different antibiotics class (WHO-ATC classification, WHO/DDD), as well as for individual drugs and their cost incurred were recorded.

Results: Of 101 patients, 68 patients (67.33%) received more than 1 antibiotic. Metronidazole was the most common antibiotic utilized at admission attributing to 29.70% and during entire ICU stay accounting to 68.32%. Metronidazole followed by ceftriaxone and piperacillin/tazobactam were the maximally utilized antibiotics with 35.32, 31.22, and 23.82, DDD/100 bed‑days, respectively. An average cost incurred to antibiotic therapy per patient was 1403 Indian rupees (INR).

Conclusion: Metronidazole followed by ceftriaxone was the most commonly prescribed antibiotics during ICU stay. A higher percentage of total cost was attributed by meropenem. Regular prescription audit and modification of antibiotic policy are required to curtail the inapt use of antibiotics and economic burden not only on patient but also on hospital pharmacy.

Key words: Antibiotic; Cost Analysis; Defined Daily Dose; Drug Utilization Study; Intensive Care Unit

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