Literature DB >> 28892925

Impact of Antibiotic Stewardship Program on Prescribing Pattern of Antimicrobials in Patients of Medical Intensive Care Unit.

Nishal Shah1, Anuradha Joshi2, Barna Ganguly3.   

Abstract

INTRODUCTION: Rising concerns about antimicrobial resistance and inadequate development of effective new anti-infective drugs have stimulated universal efforts to strengthen infection-control interventions. Antimicrobial stewardship is a rational, systematic approach to promote the optimal selection, dosing, and duration of therapy for antimicrobial agents throughout the course of their use in order to improve the outcomes. AIM: Since in Shree Krishna Hospital (SKH), Antibiotic Stewardship Program (ASP) was first implemented in 2013, this study was planned to assess any change in antimicrobial use before and after implementation of ASP and to study the rate and pattern of antimicrobial use in medical ICU.
MATERIALS AND METHODS: A cross-sectional study was conducted in 12 bedded medical intensive care unit, over a period of two years from October 2014 to October 2016 at SKH. Permission was taken from Institutional Human Research Ethics Committee. Total 150 case files i.e., 75 from year 2012 and 75 from year 2015 were retrieved from medical record section of the hospital. Appropriateness of prescriptions was decided on the basis of appropriateness of choice, dose, frequency and duration of antimicrobial agents. Data were analysed by using descriptive statistics.
RESULTS: There were 68.67% males and the mean (±SD) age was 57.11 (±16.83) years. Majority of the patients were suffering from respiratory conditions. The most common group of drugs prescribed in MICU was β-lactam antibiotics + β-lactamase inhibitors during 2012 as well as 2015. Total 139 patients i.e., 69 (92%) patients in 2012 and 70 (93.33%) patients in 2015 were given antimicrobial for therapeutic purpose. During the year 2015, 67 (89.33%) antimicrobial prescriptions were adhering to antibiotic policy of SKH. Appropriateness of prescriptions had significantly improved in 2015 in MICU (p-value=0.031).
CONCLUSION: In-depth analysis of the study revealed a positive impact of ASP and antibiotic policy. Implementation of ASP in year 2013, brought an effective increase in the appropriate use of antimicrobials.

Entities:  

Keywords:  Antimicrobial agents; Expenditures; Prescriptions

Year:  2017        PMID: 28892925      PMCID: PMC5583932          DOI: 10.7860/JCDR/2017/27171.10237

Source DB:  PubMed          Journal:  J Clin Diagn Res        ISSN: 0973-709X


  21 in total

Review 1.  Appropriate use of antimicrobial agents: challenges and strategies for improvement.

Authors:  Michael S Niederman
Journal:  Crit Care Med       Date:  2003-02       Impact factor: 7.598

Review 2.  Antimicrobial stewardship programs in health care systems.

Authors:  Conan MacDougall; Ron E Polk
Journal:  Clin Microbiol Rev       Date:  2005-10       Impact factor: 26.132

Review 3.  Bad bugs need drugs: an update on the development pipeline from the Antimicrobial Availability Task Force of the Infectious Diseases Society of America.

Authors:  George H Talbot; John Bradley; John E Edwards; David Gilbert; Michael Scheld; John G Bartlett
Journal:  Clin Infect Dis       Date:  2005-01-25       Impact factor: 9.079

4.  Poor compliance with the antibiotic policy in the intensive care unit (ICU) of a tertiary care hospital in India.

Authors:  Tuhina Banerjee; Shampa Anupurba; Dinesh K Singh
Journal:  J Infect Dev Ctries       Date:  2013-12-15       Impact factor: 0.968

Review 5.  Antibiotic stewardship programmes in intensive care units: Why, how, and where are they leading us.

Authors:  Yu-Zhi Zhang; Suveer Singh
Journal:  World J Crit Care Med       Date:  2015-02-04

6.  Study of prescribing pattern of antimicrobial agents in medicine intensive care unit of a teaching hospital in Central India.

Authors:  Vandana A Badar; Sanjaykumar B Navale
Journal:  J Assoc Physicians India       Date:  2012-04

7.  Antibiotic usage in intensive care units: a pharmaco-epidemiological multicentre study.

Authors:  Paolo Malacarne; Carlotta Rossi; Guido Bertolini
Journal:  J Antimicrob Chemother       Date:  2004-06-09       Impact factor: 5.790

8.  Antibiotic prescription patterns at admission into a tertiary level intensive care unit in Northern India.

Authors:  Aparna Williams; Ashu S Mathai; Atul S Phillips
Journal:  J Pharm Bioallied Sci       Date:  2011-10

9.  Drug utilization pattern in critical care unit in a tertiary care teaching hospital in India.

Authors:  Mahendra K Patel; Manish J Barvaliya; Tejas K Patel; Cb Tripathi
Journal:  Int J Crit Illn Inj Sci       Date:  2013-10

10.  Antibiotic prescription and cost patterns in a general intensive care unit.

Authors:  Norberto Krivoy; Wissam Abed El-Ahal; Yaron Bar-Lavie; Salim Haddad
Journal:  Pharm Pract (Granada)       Date:  2007
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  2 in total

1.  Evaluating antibiotic stewardship in a tertiary care hospital in Kerala, India: a qualitative interview study.

Authors:  Kelsey Baubie; Catherine Shaughnessy; Lia Kostiuk; Mariam Varsha Joseph; Nasia Safdar; Sanjeev K Singh; Dawd Siraj; Ajay Sethi; Julie Keating
Journal:  BMJ Open       Date:  2019-05-14       Impact factor: 2.692

2.  Challenges in Implementing Antimicrobial Stewardship Programmes at Secondary Level Hospitals in India: An Exploratory Study.

Authors:  Philip Mathew; Jaya Ranjalkar; Sujith John Chandy
Journal:  Front Public Health       Date:  2020-09-18
  2 in total

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