# Utilization of Antimicrobial Agents in Intensive Care Units of Tertiary Care Hospital: An Observational Study

## TL;DR

This study analyzed antibiotic use in a hospital's ICU over three years, finding increased overall usage and a significant rise in specific types of antibiotics.

## Contribution

The study provides a detailed analysis of antibiotic consumption trends in a Nepalese ICU, highlighting shifts in antibiotic group usage over time.

## Key findings

- Antibiotic consumption increased from 324.2 to 564.25 DOT/1000 PD between 2018 and 2020.
- Watch group antibiotic use nearly doubled, while Reserve group usage declined.
- Piperacillin/tazobactam, ceftriaxone, azithromycin, and vancomycin saw significant usage increases.

## Abstract

The rising incidence of antibiotic resistance is a global threat. Monitoring antibiotic use is one of the strategies to address this issue. Intensive Care Units (ICUs) have high prevalence of antibiotic use and multidrug-resistant organisms. This study aims to study the status of antibiotic usage within the ICU in a tertiary care center.

An observational cross-section study was conducted from July 15, 2021 to December 20, 2021 in the adult intensive care unit and record section of a tertiary care hospital of Nepal after approval from Institutional Review Committee. Data were collected from medical records of patients admitted to the ICU from January 1, 2018 to December 31, 2020 and who received antibiotics. Data were presented in terms of days of therapy per 1000 patient days (DOT/1000PD).

Total antibiotic consumption increased from 324.2 DOT/1000 PD in 2018 to 564.25 DOT/1000 PD in 2020. Consumption of Watch group antibiotic nearly doubled from 248.21 to 473.23 DOT/1000 PD, while Access antibiotics increased from 49.09 to 73.5 DOT/1000 PD. In contrast, Reserve group antibiotic usage declined from 26.91 to 17.49 DOT/1000 PD. In 2018, highest consumed antibiotics were piperacillin/tazobactam 57.89 (17.89%), azithromycin 53.98 (16.70%), ceftriaxone 49.58 (15.34%) and vancomycin 43.87 (13.57%) DOT/1000 PD. By 2020, their usage increased to 129.87 (23.02%), 69.38 (12.30%), 94.29 (16.71%), and 87.77 (15.55%) DOT/1000 PD respectively.

Total antibiotic consumption increased over the years. There was a substantial rise in the use of Watch group antibiotics, particularly piperacillin/tazobactam, ceftriaxone, azithromycin, and vancomycin. Meanwhile, the use of Reserve group antibiotics declined during the same period.