Publication:

Drug utilization pattern in ICU in a tertiary health care institution

Background The objective of the study was to evaluate the current prescription pattern of drug utilization so as to find out drug use indicators such as utilization of drugs per prescription that can reflect possibilities of drug interaction and patient compliance and to suggest measures for rational prescriptions in patients admitted in Intensive Care Unit for various medical and surgical indications.

Methods It was a retrospective, observational hospital based study which was done for 1 year after obtaining permission from the Institutional Human Ethics Committee. The prescriptions of both genders and of any age groups suffering from any medical or surgical indication who were admitted in Intensive Care Unit were included. The parameters assessed were demographic profile of the patient, most common diagnosis, number of days of ICU stay, ICU outcome, number of drugs/prescription, most common group and route of drugs.

Results Data collected from 560 prescriptions were analyzed using appropriate statistical method and 66% patients were male. Most common age group was 41-60(40%). Cerebrovascular accident (22.9%) was the most common diagnosis followed by septicaemia (20.7%). Average no. of days of ICU stay was 6.22 days/patient. ICU mortality rate was 58.6% which was the most common outcome. At an average 15.8 drugs were prescribed per patient. Antibiotics and proton pump inhibitors were the most commonly prescribed drugs in 100% prescriptions, ceftriaxone (37.1%) being the most common antibiotic. Most common route of drug administration was intravenous route (65%).

Conclusions Prescribing guideline is required to reduce the prevalent poly-pharmacy and to promote appropriate use of antimicrobials based on the culture and sensitivity report.