Arabian Gulf University, Manama, Bahrain.
Salmaniya Medical Complex, Manama, Bahrain.
Anaesthesiol Intensive Ther. 2021;53(1):18-24. doi: 10.5114/ait.2021.103628.
Critically ill adults, children and neonates receive drugs that are often administered parenterally and in infusions. Considering patient illness severity, empirical broad-spectrum antimicrobials are commonly used. We conducted the present study to evaluate the drug use in this population, with a special focus on antimicrobials.
A prospective cross-sectional study was implemented in adult, paediatric and neonatal intensive care units. Various prescribing and supplemental indicators were used for drug comparisons. The World Health Organisation's list of essential drugs, the national drug formulary and critically important antimicrobial drugs were assessed. Proportions and median (range) were used to represent categorical and numerical values.
Four hundred and ninety-six critically ill patients were enrolled in the study, with 5,636 prescribed drugs used for 31,993 patient-days. Critically ill adults received significantly more drugs compared to children and the neonatal population (11 [8-16], 9 [6-17] and 5 [3-12] respectively). Critically ill neonates received significantly fewer of the drugs listed in the national formulary compared to older children and adults (94.1% [10.1], 92.4% [32.4] and 80.1% [20.4]). Critically ill neonates received fewer antimicrobials (82% compared to 91.3% in adults and 98% in children). Furthermore, critically ill adults received more broad-spectrum antimicrobials compared to neonates. Prolonged empirical antimicrobial use was observed more in critically ill children (52%) compared to adults (29.8%). A large majority of the antimicrobials were critically important for 87.7%, 83.9% and 86.5% of patients in the adult, paediatric and neonatal intensive care units.
We observed significant differences in terms of drug classes predominantly used in various age groups of critically ill patients, particularly regarding the nature and type of antimicrobial drugs and the duration of antimicrobial therapy.
危重症成人、儿童和新生儿接受的药物通常为肠外和输注给药。鉴于患者的疾病严重程度，通常会使用经验性广谱抗生素。本研究旨在评估此类人群的药物使用情况，特别关注抗生素。
在成人、儿科和新生儿重症监护病房进行了一项前瞻性的横断面研究。使用各种处方和补充指标进行药物比较。评估了世界卫生组织的基本药物清单、国家药物处方集和极重要的抗菌药物。使用比例和中位数（范围）来表示分类和数值。
本研究共纳入 496 名危重症患者，共使用 5636 种药物治疗 31993 名患者/天。危重症成人接受的药物明显多于儿童和新生儿（分别为 11[8-16]、9[6-17]和 5[3-12]）。危重症新生儿接受的国家处方集药物明显少于大龄儿童和成人（94.1%[10.1]、92.4%[32.4]和 80.1%[20.4]）。危重症新生儿接受的抗生素明显少于成人（82%比成人的 91.3%和儿童的 98%）。此外，危重症成人接受的广谱抗生素明显多于新生儿。危重症儿童（52%）比成人（29.8%）更长期使用经验性抗生素。大多数抗生素对成人、儿科和新生儿重症监护病房的 87.7%、83.9%和 86.5%的患者非常重要。
我们观察到不同年龄组危重症患者使用的药物类别存在显著差异，特别是在抗生素药物的性质和类型以及抗生素治疗的持续时间方面。
