A Study of Drug Utilization Pattern According to Daily Define Dose in Intensive Care Unit (ICU)s at Tertiary Care Teaching Hospital, India

Objective: The goal of study is to identify drug and antimicrobial utilization in ICUs by using daily defined dose. Material and Methods: Study was conducted at tertiary care teaching hospital. 100 patients in each medical, surgical and neurosurgical ICU were included. The data were recorded in preformed Case Record Form (CRF). Drugs were classified using the anatomical therapeutic chemical (ATC) classification system and drug utilization was measured as Daily Defined Dose (DDD)/100 bed days. Data were analyzed by Z and x2 test. Results: DDD/100 bed days of inotropes was 51.44 in medical ICU which was significantly (p<0.05) higher compared to surgical and neurosurgical ICU while DDD/100 bed days of gastrointestinal drugs was 44.52, 38.57 and analgesics was 34.5, 34.41 in surgical and neurosurgical ICU respectively which was significantly (p<0.05) higher as compared to medical ICU. More than two antimicrobials were prescribed in above 70% patients in all ICU. DDD/100 bed days of cephalosporin was 20.76 in medical ICU which was significantly(p<0.05) higher compared to surgical and neurosurgical ICU. DDD/100 bed days of aminoglycosides was 16.01, 17.65 and nitroimidazole was 10.3, 8.4 in surgical and neurosurgical ICU respectively which was significantly (p<0.05) higher compared to medical ICU. Among restricted antimicrobials according to antimicrobial policy of hospital. DDD/100 bed days of piperacillin+tazobactam and cefoperazone+sulbactam were significantly (p<0.05) higher in medical ICU. Levoflxoacin and vancomycin were highly sensitive antimicrobials followed by beta lactam antimicrobials with beta lactamase inhibitors in all ICUs. Conclusion: Polypharmacy was observed in ICU and antimicrobials widely prescribed in ICUs. Sensitivity of beta lactam along with beta lacatamase inhibitors was high.