Iqbal Muhammad Shahid, Khan Mohd Faiyaz, Farooqui Sadaf, Khan Salah-Ud-Din, Vohra Saeed, Rasheed Shahzad, Iqbal Muhammad Zahid, Qamer Shafqat
Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.
Department of Biochemistry, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 11432, Saudi Arabia.
Medicina (Kaunas). 2025 Mar 10;61(3):481. doi: 10.3390/medicina61030481.
Irrational use and overuse of antibiotics is considered a major cause of antimicrobial resistance (AMR) among patients admitted to hospitals, especially in intensive care units (ICUs). ICUs are the most critical wards in healthcare settings, where the use of antibiotics is much higher compared to other wards. Therefore, the appropriate administration and monitoring of antibiotic usage in these units is a matter of concern. This retrospective study evaluated the types, utilization patterns, sensitivity, and resistance of various antibiotics used among patients admitted to the ICUs of different hospitals after the third wave of the coronavirus disease in 2019 (COVID-19) in Pakistan. It was observed that more than 40% of the patients were given two antibiotics and 54.3% were given at least one antibiotic each day. A total of 768 antibiotics from different groups, based on the World Health Organization (WHO) Access, Watch, and Reserve (AWaRe) classification, were prescribed to 313 patients admitted to ICUs between April and August 2021. Among the types of antibiotics, amoxicillin/clavulanic acid was the most frequently used antibiotic (75 prescriptions). It was also observed that the majority of the bacterial isolates were more sensitive to carbapenems than the other antibiotics. The current study showed that antibiotic usage according to the AWaRe classifications was 31.8% in the Access category, 59.5% in the Watch category, and 8.7% in the Reserve category in ICUs of the studied hospitals after the third wave of COVID-19. The findings of the study also highlight the importance and continuous need for the implementation of antibiotic stewardship programs to optimize the appropriate utilization of antibiotics in the ICUs of the studied hospitals.
抗生素的不合理使用和过度使用被认为是医院住院患者，尤其是重症监护病房（ICU）患者产生抗菌药物耐药性（AMR）的主要原因。ICU是医疗机构中最关键的病房，与其他病房相比，抗生素的使用量要高得多。因此，在这些病房中合理使用和监测抗生素的使用情况是一个值得关注的问题。这项回顾性研究评估了2019年冠状病毒病（COVID-19）第三波疫情后巴基斯坦不同医院ICU收治患者使用的各类抗生素的种类、使用模式、敏感性和耐药性。研究发现，超过40%的患者每天使用两种抗生素，54.3%的患者每天至少使用一种抗生素。2021年4月至8月期间，根据世界卫生组织（WHO）的“准入、观察和储备”（AWaRe）分类，共向313名入住ICU的患者开具了768种不同组别的抗生素。在抗生素类型中，阿莫西林/克拉维酸是最常用的抗生素（75张处方）。研究还发现，大多数细菌分离株对碳青霉烯类抗生素的敏感性高于其他抗生素。当前研究表明，在研究医院的ICU中，COVID-19第三波疫情后，按照AWaRe分类，准入类抗生素的使用比例为31.8%，观察类为59.5%，储备类为8.7%。该研究结果还凸显了实施抗生素管理计划以优化研究医院ICU中抗生素合理使用的重要性和持续需求。
