Antimicrobial utilization in Intensive care units of a private tertiary care hospital

OBJECTIVE - To evaluate the utilization of antimicrobials in ICUs of a private tertiary care hospital using RPM Plus indicators. METHODOLOGY - A prospective observational study was conducted at two ICUs of the hospital Coronary Care Unit (CCU) and Surgical ICU (SICU). RESULTS & DISCUSSIONS -The number of patient records studied in SICU and CCU were 305 and 410, respectively. In SICU, the average number of total medications was 11.71 +/- 0.16, of which the average number of AMDs was found to be 1.32 +/- 0.04. For CCU, the average number of medications was 9.37 +/- 0.15 and out of this, the average number of AMDs prescribed was 1.79 +/- 0.05. 95% of AMDs were administered parenterally in SICU while it was 78.2% in CCU; however, this difference was statistically insignificant (p=0.546). The percentage of AMD prescribed by its generic name was 13.8% in SICU and 8.9% in CCU. AMDs prescribed from the National List of Essential Medicines (NLEM) in CCU were two times the numbers prescribed in SICU (42.5% vs 20.8%). CONCLUSION AMD consumption was found to be greater in CCU than SICU and the possible reasons could be that the patients admitted in CCU were relatively older and also because generally one antibiotic is used for surgical prophylaxis in SICU. There is a scope for improvement in the prescription of AMDs by generic name and also from the National List of Essential Medicines of India.