Utilization of antimicrobial agents in medical intensive care unit of a teaching hospital

Objective: To study the prescribing pattern of antimicrobial agents in medical intensive care unit and to determine the outcome in these patients. Materials and methods: Study was conducted by the Department of Pharmacology by obtaining the data of patients admitted to medical intensive care unit (MICU) of RLJH & RC attached to SDUMC, Kolar during January to June 2012. The demographic data, diagnosis, dosage schedule of the antimicrobials used, duration of stay and the outcome were recorded as per predesigned proforma. Results: There were 408 patients of which 242 were males (59%). The mean age was 46.63 ± 18.28 years. Indications for admission were respiratory tract infections (20.83%) followed by fever for evaluation (16.91%) and poisoning (15.44%). Commonest being pneumonia, COPD, dengue fever and OP poisoning. 353 patients (86.51%) received antimicrobial therapy. Prophylactic and therapeutic use was 55.52% and 44.48% respectively. In 111 patients (27.20%) two antimicrobials were used, 94 (23.03%) and 87 (21.32%) patients received one and three antimicrobials respectively. Commonly used agents were third generation cephalosporins – ceftriaxone (71.67%) followed by metronidazole (33.71%), doxycycline (24.64%) and penicillins – piperacillin and tazobactum (23.79%). Only in 10 patients (2.45%) antimicrobial therapy was changed after culture and sensitivity report. The mean duration of stay in MICU was 3.01 ± 2.27 days. 307 (75.24%) patients recovered. Conclusion: Majority of the patients in MICU received antimicrobials, commonest being cephalosporins. Most of our patients received 2 antimicrobials and only 15% received more than three. Change in the drug following culture and sensitivity was observed in few patients