Shridhar Deepthi P, Anitha K B, Rai Mohandas, Fernandes Anisha
Postgraduate, Department of Pharmacology, A.J. Institute of Medical Sciences and Research Centre , Mangalore, India .
Professor, Department of Microbiology & Co-ordinator HICC, A.J. Institute of Medical Sciences and Research Centre , Mangalore, India .
J Clin Diagn Res. 2015 Feb;9(2):FC05-9. doi: 10.7860/JCDR/2015/10974.5593. Epub 2015 Feb 1.
A world without effective antibiotics is a terrifying but a real prospect. Overuse or misuse especially of newer and higher antimicrobials (AM) is of particular concern, as this contributes to development of resistance among microorganisms. To check this trend, the Reserve Drug Indent Form (RDIF) was introduced in our hospital and its impact on AM consumption, cost of therapy and the sensitivity pattern was studied in the medical intensive care unit (MICU).
A retrospective descriptive study in the medical ICU of a tertiary care hospital from July 2012 to August 2013. From March 2013, RDIF was made mandatory to be filled up prior to prescribing reserve antimicrobials. AM consumption (expressed as DDD/100 bed days) and sensitivity pattern (expressed in percentage) six months prior to and six months after implementation of the form were analysed.
The total Reserve AM consumption was 125.79 per 100 bed days during the study period. Average occupancy index was 0.50 and length of ICU stay was 6 days. The total consumption reduced from 85.55/100 to 40.24/100 bed days after the introduction of the RDIF. However, Imipenem usage increased from 11.35/100 to 23.94/100 bed days, which can be attributed to sensitivity profile to Imipenem (82.1%) compared to Meropenem (65.7%). Cost of therapy reduced from Rs 6,27,951 to 4,20,469.
Reserve AM consumption showed a declining trend after introduction of the RDIF. Hence, the RDIF served as an important tool to combat inappropriate use, reducing the cost burden and also helped to improve the sensitivity to reserve drugs.
一个没有有效抗生素的世界是可怕但真实的前景。过度使用或滥用，尤其是新型和高级抗菌药物，是特别令人担忧的问题，因为这会导致微生物产生耐药性。为遏制这一趋势，我院引入了储备药物申请表（RDIF），并在医学重症监护病房（MICU）研究了其对抗菌药物消耗、治疗成本和药敏模式的影响。
对一家三级护理医院的医学重症监护病房在2012年7月至2013年8月期间进行回顾性描述性研究。从2013年3月起，规定在开具储备抗菌药物前必须填写RDIF。分析了该表格实施前六个月和实施后六个月的抗菌药物消耗量（以每100床日限定日剂量表示）和药敏模式（以百分比表示）。
研究期间储备抗菌药物的总消耗量为每100床日125.79。平均占用指数为0.50，重症监护病房住院时间为6天。引入RDIF后，总消耗量从每100床日85.55降至40.24。然而，亚胺培南的使用量从每100床日11.35增加到23.94，这可能归因于亚胺培南的药敏率（82.1%）高于美罗培南（65.7%）。治疗成本从627951卢比降至420469卢比。
引入RDIF后，储备抗菌药物的消耗量呈下降趋势。因此，RDIF是对抗不当使用的重要工具，减轻了成本负担，也有助于提高对储备药物的敏感性。
