A Study of Utilization of Antimicrobial Agents in Patients on Ventilator in Intensive Care Unit (I CU ) at Tertiary Care Teaching Hospital, India

Shelat, Prakash R; Gandhi, Arun; Patel, Prakruti

doi:10.7860/jcdr/2014/11184.5156

Cited by 1 publication

(1 citation statement)

References 16 publications

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“…The inappropriate use of antibiotics was observed in 24.8% of cases, as per the current guidelines established by the IDSA (22).This rate is relatively lower than what has been reported in previous studies conducted in Ethiopia, Turkey, Pakistan, and India (9,(23)(24)(25). One possible explanation for this variation could be the in uence of healthcare institution-level practices, which can signi cantly impact the appropriateness of antibiotic use and prescribing behaviors.…”

Section: Discussionmentioning

confidence: 75%

Exploring Antibiotic Appropriateness and Clinical Outcomes among Adult Intensive Care Unit Patients in Two Tertiary Hospitals in Ethiopia: A Prospective Observational Study

Tilahun,

Kumsa,

Gebre

et al. 2023

Preprint

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Background: Antimicrobial resistance, driven by antimicrobial misuse, poses a global threat. Research on antibiotic utilization in Ethiopian intensive care units (ICUs) is lacking. This study seeks to assess the judiciousness of antibiotic utilization and its ramifications on clinical outcomes for adult ICU patients in two tertiary hospitals. Methods: This study, conducted between April 1, 2021, and September 30, 2021, examined antibiotic appropriateness in adult ICU patients, following Infectious Disease Society of America (IDSA) guidelines. Data, including socio-demographics, clinical profiles, antibiotic use, and clinical outcomes, were analyzed using EpiData version 4.6 and SPSS version 25. Logistic regression and Cox proportional hazard ratios identified factors associated with inappropriate antibiotic use and ICU mortality. Results: The study enrolled a total of 206 participants, with 113 (54.9%) being male and 124 (60.2%) residing in urban areas. Approximately 24.8% of patients received antibiotics in a manner inconsistent with IDSA guidelines. Independent factors associated with inappropriate antibiotic use included male gender (Adjusted Odds Ratio [AOR] = 3.6, 95% Confidence Interval [CI] 1.65, 7.70) and the administration of two or more antibiotics (AOR = 4.5, 95% CI 1.29, 15.84). The ICU mortality rate was 21.8%, with comorbid conditions (Adjusted Hazard Ratio [AHR] = 3.7, 95% CI 1.55, 8.87) and inappropriate antibiotic administration (AHR = 10.7, 95% CI 4.56, 25.1) identified as independent risk factors exacerbating ICU mortality. Conclusion: Inappropriate antibiotic use is a pressing public health concern in the study's setting, underscoring the need for robust policies to reduce it in ICUs. The study found that male gender and the concurrent use of multiple antibiotics are significant factors linked to inappropriate antibiotic utilization in ICUs. Targeted interventions are essential to enhance patient care and combat antimicrobial resistance.

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Section: Discussionmentioning

confidence: 75%