Trends in antibacterial drug consumption in the intensive care unit

Abstract

Adequate use of antibacterials in the ICU is important to help achieve optimum end results. The aim of this study was to present a scenario analysis of the past and current use of antibacterial drugs in the ICU. Special observation was given on respective classes, dosage regimens and indications for administration. The study was carried out at the ICU at Mater Dei Hospital (MDH). Past data was retrieved on an excel database from hospital data, showing annual antibacterial consumption. Present data was collected by manual records taken every 2 weeks for a period of 4 months from the ICU, through a devised ‘Antibacterial Collection Sheet’. Critically ill patients over 18 years of age were included. The Anatomical Therapeutic Classification (ATC) / Defined Daily Doses (DDD) methodology as designated by WHO was applied. Administration of antibacterials at MDH ICU between 2009-2017 and in 2019 was analysed. During the period 2009-2017, an increasing trend in DDD/patient value was observed, with the highest value noted for the year 2015 at, 1872.4. Meropenem and Piperacillin, with a betalactamase inhibitor were the two most commonly administered antibacterials during the years, with average yearly DDD values of 3577 and 1362 respectively. The prospective study carried out in 2019, included data of 68 patients, 76% (N=68) of which were male. The age range of these patients was of 21-89 years, with a mean age of 60 years. Fourty-seven% (N=68) were administered an antibacterial for a respiratory infection. The most frequently administered antibacterial was piperacillin/ tazobactam, at 27% (N=68), followed by meropenem, at 19.4% (N=68) of the total number of antibacterials administered. Gentamicin and cefuroxime were among the least frequently prescribed antibacterials, both at less than 1% (N=68). Data presented in this drug utilization study incorporates data from medical and surgical patients in the ICU. Carbapenems and Penicillins with Beta-lactamase inhibitor, were the two most commonly administered antibacterial classes from both the retrospective and prospective study data.