Evaluation of Antibiotic Utilization Pattern in Critical Care Units in a Hospital in Egypt

Abstract

Abstract Background Monitoring antibiotic utilization in ICUs is crucial as misuse of antibiotics contributes to development of multidrug-resistant bacteria which increases the risk of treatment failure, prolonged ICU stays, and higher mortality rates. Objective Measure the utilization of antibiotics used in ICU in an Egyptian hospital, compare between PDD and DDD, and describe pattern of antibiotics used in this ICU. Methods This cross-sectional prospective study included 103 patients records, reviewed for antibiotic utilization in ICU. Data collection included patient demographics, LOS, diagnosis, admission reason, and antibiotics data. Antibiotics were classified using ATC classification system and antibiotic utilization was measured as PDD/WHO DDD ratio and DDD/100 patient days. Pattern of antibiotics use were analyzed according to appropriateness and indication; prophylactic or therapeutic reasons and empirically or culture-based. Results a sample of 103 patients, mean age was 58.5 years, mean LOS was 4 days. Patients were admitted for medical and surgical reasons 72 (70%), 31(30%) patients, respectively. The most antibiotic prescribed was ceftriaxone 53(30%) then meropenem, penicillin with tazobactam were both the same 22 (13%). PDDs of most antibiotics were nearly equal to WHO DDD. DDDs/100 patient days for Ceftriaxone, Meropenem, Piperacillin/Tazobactam, Cefazolin and Teicoplanin were 55.04 gm./100 patient days, 24.16 gm./100 patient days, 28.46 gm./100 patient days, 4.09 gm./100 patient days and 9.81 gm./100 patient days, respectively. Therapeutic antibiotics were 155 (88%), prophylactic antibiotics were 21 (12%), culture-based antibiotics were 11(7%) and empiric antibiotics 144 (93%). Proper antibiotics were 154 (87.5%) while improper antibiotics were 22 (12.5%). Conclusion This study highlights that the most antibiotics prescribed were ceftriaxone, Meropenem and Piperacillin/Tazobactam respectively, PDDs of most antibiotics were nearly equal to DDD approved by WHO.