Khirasaria Raj, Kanani Neeta, Batta Angelika
Department of Pharmacology, Medical College Baroda and SSG Hospital, Vadodara, Gujarat, India.
Department of Pharmacology, Maulana Azad Medical College, New Delhi, India.
Perspect Clin Res. 2019 Jul-Sep;10(3):130-136. doi: 10.4103/picr.PICR_54_18.
The burden of bacterial infections is huge and grossly underrepresented in the current health-care system. Inappropriate use of antimicrobial agents (AMAs) poses a potential hazard to patients by causing antibiotic resistance. In addition, the field of antimicrobials is witnessing constant development and introduction of new drugs for which holistic utilization, effectiveness, and side-effects studies are the need of the hour. The current study aims at studying the prescription pattern of AMAs in patients on ventilator and focuses on their prescribing trends.
A prospective, observational study was conducted in Medical Intensive Care Unit (ICU) of a tertiary care hospital of Western India for 6 months. Prescription pattern of AMAs was analyzed using predesigned format.
Descriptive statistics was used being an observational study.
Five-hundred and twenty patients who were on ventilator and were prescribed one or more AMAs were enrolled in the study with a mean patient age of 40.7 years. The intended purpose of the use of AMAs was prophylactic in 59% of patients. Empirical therapy was given in 92% of patients. β-lactams group of AMAs along with metronidazole were most frequently used. 73% required concurrent use of two or more AMAs. 9% of the patients required addition or substitution of one or more other AMAs on the basis of culture and sensitivity report or inadequate clinical response and expert opinion. The outcome of therapy with AMAs showed infection was effectively prevented in 34% of the patients.
This study provides a baseline data for improving the utilization of AMAs in ICU settings by rationalizing their use and also carrying out further studies on prescribing pattern of AMAs in a tertiary care unit.
细菌感染的负担巨大，而在当前医疗体系中却严重未得到充分体现。抗菌药物的不当使用会导致抗生素耐药性，从而对患者构成潜在危害。此外，抗菌药物领域不断有新药研发和引入，当下急需对这些药物进行全面的利用、有效性及副作用研究。本研究旨在探讨使用呼吸机患者的抗菌药物处方模式，并关注其处方趋势。
在印度西部一家三级医院的医学重症监护病房（ICU）进行了一项为期6个月的前瞻性观察研究。使用预先设计的格式分析抗菌药物的处方模式。
作为一项观察性研究，采用描述性统计方法。
本研究纳入了520例使用呼吸机且被开具一种或多种抗菌药物的患者，患者平均年龄为40.7岁。59%的患者使用抗菌药物的预期目的是预防性的。92%的患者接受了经验性治疗。抗菌药物中β-内酰胺类药物联合甲硝唑使用最为频繁。73%的患者需要同时使用两种或更多种抗菌药物。9%的患者根据培养和药敏报告或临床反应不佳及专家意见需要加用或更换一种或多种其他抗菌药物。抗菌药物治疗结果显示，34%的患者感染得到有效预防。
本研究通过合理使用抗菌药物并在三级医疗机构中对抗菌药物处方模式开展进一步研究，为改善ICU环境中抗菌药物的使用提供了基线数据。
