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VOLUME 20 , ISSUE 5 ( 2016 ) > List of Articles


Antimicrobial agents' utilization and cost pattern in an Intensive Care Unit of a Teaching Hospital in South India

Nikhilesh Anand, I. M. Nagendra Nayak, M. V. Advaitha, Noble J. Thaikattil, Kiran A. Kantanavar, Sanjit Anand

Keywords : Antimicrobial agents, cost analysis, DDD/ATC, drug utilization study, Intensive Care Unit

Citation Information : Anand N, Nagendra Nayak IM, Advaitha MV, Thaikattil NJ, Kantanavar KA, Anand S. Antimicrobial agents' utilization and cost pattern in an Intensive Care Unit of a Teaching Hospital in South India. Indian J Crit Care Med 2016; 20 (5):274-279.

DOI: 10.4103/0972-5229.182200

License: CC BY-ND 3.0

Published Online: 01-12-2013

Copyright Statement:  Copyright © 2016; The Author(s).


Background and Aims: High utilization and inappropriate usage of antimicrobial agents (AMAs) in an Intensive Care Unit (ICU) increases resistant organisms, morbidity, mortality, and treatment cost. Prescription audit and active feedback are a proven method to check the irrational prescription. Measuring drug utilization in DDD/100 bed-days is proposed by the WHO to analyze and compare the utilization of drugs. Data of AMAs utilization are required for planning an antibiotic policy and for follow-up of intervention strategies. Hence, in this study, we proposed to evaluate the utilization pattern and cost analysis of AMA used in the ICU. Methodology: A prospective observational study was conducted for 1 year from January 1, 2014, to December 31, 2014, and the data were obtained from the ICU of a tertiary care hospital. The demographic data, disease data, relevant investigation, the utilization of different classes of AMAs (WHO-ATC classification) as well as individual drugs and their costs were recorded. Results: One thousand eight hundred and sixty-two prescriptions of AMAs were recorded during the study period with an average of 1.73 ± 0.04 prescriptions/patient. About 80.4% patients were prescribed AMAs during admission. Ceftriaxone (22.77%) was the most commonly prescribed AMA followed by piperacillin/tazobactam (15.79%), metronidazole (12%), amoxicillin/clavulanic acid (6.44%), and azithromycin (4.34%). Ceftriaxone, piperacillin/tazobactam, metronidazole, and linezolid were the five maximally utilized AMAs with 38.52, 19.22, 14.34, 8.76, and 8.16 DDD/100 bed-days respectively. An average cost of AMAs used per patient was 2213 Indian rupees (INR). Conclusion: A high utilization of AMAs and a high cost of treatment were noticed which was comparable to other published data, though an increased use of newer AMAs such as linezolid, clindamycin, meropenem, colistin was noticed.

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