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Int J Crit Illn Inj Sci. 2013 Oct;3(4):250-5. doi: 10.4103/2229-5151.124128.

Drug utilization pattern in critical care unit in a tertiary care teaching hospital in India.

Author information

1
Department of Pharmacology, Government Medical College, Bhavnagar, India.
2
Department of Pharmacology, GMERS Medical College, Gotri, Vadodara, Gujarat, India.

Abstract

AIMS:

The aim of this study is to evaluate the drug utilization pattern and pharmacoeconomic analysis in critical care unit (CCU).

MATERIALS AND METHODS:

Indoor case papers of patients admitted in CCU between January 2008 and December 2010 were analyzed for demographic variables; indications; duration of CCU stay; proportion of common drugs used. Use of antimicrobials was evaluated based on the culture report and empirical regimen used. Defined daily dose (DDD)/100 bed-days were calculated. Various World Health Organization prescribing indicators were evaluated. Cost of drugs was calculated from Indian Drug Review (2010).

RESULTS:

A total of 397 cases were evaluated with a mean age of 44.62 years (95% confidence interval [CI]: 42.56-46.69). Average duration of CCU stay was 4.15 days (95% CI: 3.79-4.51). The average number of drugs prescribed per patient was 13.54 (95% CI: 13.05-14.04). Total drug utilization in terms of DDD/100 bed-days was 226.27. Metronidazole, cefotaxime, atropine, adrenaline, dopamine, dobutamine, deriphyllin, ranitidine, metoclopramide and furosemide were prescribed in more than 30% cases. Number of antimicrobials prescribed per patient was 2.50 (95% CI: 2.37-2.66). Cefotaxime + metronidazole (26.70%) were the most common empirical regimen used. Average cost of treatment per patient was Rs 3225.70 (95% CI: 2749.8-3701.6). Higher economic burden was noted among expired patients and admitted due to medical + surgical indication (P < 0.05).

CONCLUSION:

Poly-pharmacy and use of antimicrobials without culture report is a common problem in CCU.

KEYWORDS:

Antimicrobial resistance; critical care unit; drug utilization research; pharmacoeconomic; pharmacoepidemiology

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