Antibiotic utilization, sensitivity, and cost in the medical intensive care unit of a tertiary care teaching hospital in Nepal

Marasine, Nirmal Raj; Shrestha, Shakti; Sankhi, Sabina; Paudel, Nabina; Gautam, Anirudh; Poudel, Arjun

doi:10.1177/20503121211043710

Cited by 9 publications

(6 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the total expenditure reported in our study was much lesser than reported in similar studies, which might be due to the fact that these studies included only intensive care unit patients. 28,29 In our study, aminopenicillins and beta-lactamase inhibitors were the highest prescribed AMMs, followed by nitroimidazoles, aminoglycosides and fluoroquinolones, which was similar to what was reported in other studies. 15,30 Though the consumption of carbapenems, polymixins, glycopenptides, lincomycins and teicoplaninlike higher AMMs was the highest in high-income regions, our study reported significantly lower expenditure on these AMMs.…”

Section: Discussionsupporting

confidence: 90%

An audit of drug utilization patterns, rationality, and cost analysis of antimicrobial medicines in a tertiary care teaching hospital in central suburban India

Panchawagh

Pol

Bhosale

et al. 2022

Int J Basic Clin Pharmacol

View full text Add to dashboard Cite

Background: Antimicrobial medicine (AMM) utilization patterns and rational drug use are important topics in today’s world wrought with AMM resistance, irrational prescription of antibiotics, and lack of proper training such as stewardship programmes for medical graduates and general practitioners. Our objective was to perform an audit of the antimicrobial drug utilization pattern, evaluate the rationality of drug use, and perform a cost analysis of these drugs.Methods: An observational cross-sectional study design was implemented. The study location was a tertiary care teaching hospital in suburban central India. Patients were recruited from the general medicine and general surgery departments.Results: Out of 189 patients, the average age was 45.714 years and 67.725% were females. A total of 595 AMMs were prescribed to 189 patients with an average of 3.148±1.578 drugs per patient. 6.5% drugs prescribed were generic, 95% prescribed were included in the national essential medicine list, and 90% of patients’ prescriptions were rational. The total expenditure on AMMs was ₹726043.610, with a median expenditure of ₹987.320.Conclusions: Drug utilization patterns vary between medicine and surgery departments. They also vary between different institutions within the same country. Creating a structured standardized training program to uniformly train healthcare professionals in conservative antibiotic prescription practices is needed. This study hopefully paves the way for future studies to target critical areas in AMM prescription and to prospectively assess the impact of a structured antibiotic stewardship program on AMM utilization patterns.

show abstract

Section: Discussionsupporting

confidence: 90%

An audit of drug utilization patterns, rationality, and cost analysis of antimicrobial medicines in a tertiary care teaching hospital in central suburban India

Panchawagh

Pol

Bhosale

et al. 2022

Int J Basic Clin Pharmacol

View full text Add to dashboard Cite

show abstract

“…While in the Emergency Department of a tertiary care hospital in Saudi Arabia, the average cost of prescribed antibiotics was equivalent to 17.8 ± 11.6 USD only [ 43 ]. Another study in the medical intensive care unit (ICU) of a tertiary care teaching hospital in Nepal showed that the average cost of antibiotics per patient was 47.67 ± 63.73 USD [ 44 ]. A study in India reported that the average cost of antibiotics per patient in the ICU was 32.58 USD [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of antibiotic prescribing pattern and cost for hospitalized patients: A study from Palestine

Manassrah,

Al Ramahi

2024

PLoS ONE

View full text Add to dashboard Cite

Background One of the largest problems facing the world today is the morbidity and mortality caused by antibiotic resistance in bacterial infections. A major factor in antimicrobial resistance (AMR) is the irrational use of antibiotics. The objective of this study was to assess the prescribing pattern and cost of antibiotics in two major governmental hospitals in the West Bank of Palestine. Methods A retrospective cohort study was conducted on 428 inpatient prescriptions containing antibiotics from two major governmental hospitals, they were evaluated by some drug use indicators. The cost of antibiotics in these prescriptions was calculated based on the local cost. Descriptive statistics were performed using IBM-SPSS version 21. Results The mean ± SD number of drugs per prescription (NDPP) was 6.72 ± 4.37. Of these medicines, 38.9% were antibiotics. The mean ± SD number of antibiotics per prescription (NAPP) was 2.61 ± 1.54. The average ± SD cost per prescription (CPP) was 392 ± 744 USD. The average ± SD antibiotic cost per prescription (ACPP) was 276 ± 553 USD. The most commonly prescribed antibiotics were ceftriaxone (52.8%), metronidazole (24.8%), and vancomycin (21.0%). About 19% of the antibiotics were prescribed for intra-abdominal infections; followed by 16% used as prophylactics to prevent infections. Almost all antibiotics prescribed were administered intravenously (IV) 94.63%. In general, the average duration of antibiotic therapy was 7.33 ± 8.19 days. The study indicated that the number of antibiotics per prescription was statistically different between the hospitals (p = 0.022), and it was also affected by other variables like the diagnosis (p = 0.006), the duration of hospitalization (p < 0.001), and the NDPP (p < 0.001). The most commonly prescribed antibiotics and the cost of antibiotics per prescription were significantly different between the two hospitals (p < 0.001); The cost was much higher in the Palestinian Medical Complex. Conclusion The practice of prescribing antibiotics in Palestine’s public hospitals may be unnecessary and expensive. This has to be improved through education, adherence to recommendations, yearly immunization, and stewardship programs; intra-abdominal infections were the most commonly seen infection in inpatients and ceftriaxone was the most frequently administered antibiotic.

show abstract

“…Quantitatively, in terms of DDD/100 bed-days, azithromycin (46.66), doxycycline (22.53), teicoplanin (22.52), and ceftriaxone (16) were the most frequently used antimicrobials in our study. Comparatively, the DDD/100 bed-days for the six most commonly prescribed antibiotics were much lesser for doxycycline (8.7), piperacillin/tazobactam (7.8), ceftriaxone (6.2), azithromycin (6.1), metronidazole (5.1), and meropenem (4.8) in a study by Marasine et al [ 26 ]. In another study conducted in western Nepal, penicillin, fluoroquinolones, second-generation cephalosporins, and third-generation cephalosporins were used at rates of 55.1, 5.34, 0.82, and 13.74 DDD/100 bed-days respectively [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment Cost Along With Pattern of Disease and Therapy in the Intensive Care Unit of a Tertiary Care Teaching Hospital in India

Atal,

Najmi,

Pathan

et al. 2024

Cureus

View full text Add to dashboard Cite

Background The intensive care unit (ICU) represents an important platform for conducting drug utilization analysis using defined daily dose (DDD)/100 bed-days and the financial burden of treatment as patients are seriously ill and are often suffering from chronic critical illnesses. Therefore, in this study, we evaluated the drug utilization patterns and cost of treatment in the ICU. Methods A retrospective observational analysis of the medical records obtained for the medical ICU of an apex tertiary care teaching hospital in central India was conducted for a period of three years from 2017 to 2019. All the patients admitted to the medical ICU during the study tenure were included in the study. Patients hospitalized in neonatal intensive care unit (NICU), pediatric intensive care unit (PICU), and surgical ICU were excluded from the study. The socio-demographic and clinical data, utilization of different classes of drugs, WHO-Anatomic Therapeutic Chemical (WHO-ATC) classification, DDD/100 bed days, hospital stay, etc. were analyzed. A partial pharmaco-economic analysis of the average cost of admission to patients was done. Results Data from 280 patients was assessed. The mean age was 47 ± 19.18 years and 58% were males. Antibiotics and injections were prescribed to 96% and 97.5% of the patients, respectively, during their ICU stay (median: seven days). Antimicrobial drugs were most frequently prescribed (n=1096, 68%); the most common were beta-lactams and carbapenems, followed by drugs acting on the central nervous system (5%) and cardiovascular system (4.3%). Cefoperazone/sulbactum, ceftriaxone, and piperacillin/tazobactam were the most utilized antibiotics with 8, 16, and 6 DDD/100 bed-days, respectively, while proton pump inhibitors, analgesics, and anti-epileptics were the most frequently prescribed non-antimicrobial drug class. The median cost of treatment per ICU admission was Indian Rupees (INR) 23,347 (IQR 12,552- 65,524). Conclusion Drug utilization assessment provides crucial information for understanding the usage of drugs in the settings of the ICU, and should be conducted regularly to help in the proper planning and implementation of rational drug use. Treatment costs reflect the high economic burden seen in ICU admissions.

show abstract

Antibiotic utilization, sensitivity, and cost in the medical intensive care unit of a tertiary care teaching hospital in Nepal

Cited by 9 publications

References 27 publications

An audit of drug utilization patterns, rationality, and cost analysis of antimicrobial medicines in a tertiary care teaching hospital in central suburban India

An audit of drug utilization patterns, rationality, and cost analysis of antimicrobial medicines in a tertiary care teaching hospital in central suburban India

Assessment of antibiotic prescribing pattern and cost for hospitalized patients: A study from Palestine

Treatment Cost Along With Pattern of Disease and Therapy in the Intensive Care Unit of a Tertiary Care Teaching Hospital in India

Contact Info

Product

Resources

About