Patel Mahendra K, Barvaliya Manish J, Patel Tejas K, Tripathi Cb
Department of Pharmacology, Government Medical College, Bhavnagar, India.
Department of Pharmacology, GMERS Medical College, Gotri, Vadodara, Gujarat, India.
Int J Crit Illn Inj Sci. 2013 Oct;3(4):250-5. doi: 10.4103/2229-5151.124128.
The aim of this study is to evaluate the drug utilization pattern and pharmacoeconomic analysis in critical care unit (CCU).
Indoor case papers of patients admitted in CCU between January 2008 and December 2010 were analyzed for demographic variables; indications; duration of CCU stay; proportion of common drugs used. Use of antimicrobials was evaluated based on the culture report and empirical regimen used. Defined daily dose (DDD)/100 bed-days were calculated. Various World Health Organization prescribing indicators were evaluated. Cost of drugs was calculated from Indian Drug Review (2010).
A total of 397 cases were evaluated with a mean age of 44.62 years (95% confidence interval [CI]: 42.56-46.69). Average duration of CCU stay was 4.15 days (95% CI: 3.79-4.51). The average number of drugs prescribed per patient was 13.54 (95% CI: 13.05-14.04). Total drug utilization in terms of DDD/100 bed-days was 226.27. Metronidazole, cefotaxime, atropine, adrenaline, dopamine, dobutamine, deriphyllin, ranitidine, metoclopramide and furosemide were prescribed in more than 30% cases. Number of antimicrobials prescribed per patient was 2.50 (95% CI: 2.37-2.66). Cefotaxime + metronidazole (26.70%) were the most common empirical regimen used. Average cost of treatment per patient was Rs 3225.70 (95% CI: 2749.8-3701.6). Higher economic burden was noted among expired patients and admitted due to medical + surgical indication (P < 0.05).
Poly-pharmacy and use of antimicrobials without culture report is a common problem in CCU.
本研究旨在评估重症监护病房（CCU）的药物使用模式及药物经济学分析。
对2008年1月至2010年12月期间入住CCU的患者的室内病历进行分析，包括人口统计学变量、适应证、CCU住院时间、常用药物使用比例。根据培养报告和经验性用药方案评估抗菌药物的使用情况。计算限定日剂量（DDD）/100床日。评估各种世界卫生组织的处方指标。药物成本根据《印度药物评论》（2010年）计算。
共评估397例病例，平均年龄44.62岁（95%置信区间[CI]：42.56 - 46.69）。CCU平均住院时间为4.15天（95%CI：3.79 - 4.51）。每位患者平均处方药物数量为13.54种（95%CI：13.05 - 14.04）。以DDD/100床日计算的总药物使用量为226.27。超过30%的病例使用了甲硝唑、头孢噻肟、阿托品、肾上腺素、多巴胺、多巴酚丁胺、二羟丙茶碱、雷尼替丁、甲氧氯普胺和呋塞米。每位患者处方的抗菌药物数量为2.50种（95%CI：2.37 - 2.66）。头孢噻肟 + 甲硝唑（26.70%）是最常用的经验性用药方案。每位患者的平均治疗成本为3225.70卢比（95%CI：2749.8 - 3701.6）。在死亡患者以及因医疗 + 手术适应证入院的患者中观察到更高的经济负担（P < 0.05）。
联合用药以及在无培养报告的情况下使用抗菌药物是CCU中的常见问题。
