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Antibiotic audit in medicine intensive care unit of tertiary care centre: A must do exercise
Institution:1. Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India;2. Department of Research, Institute of Liver and Biliary Sciences, New Delhi, 110070, India;3. Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India;1. Department of Neonatology, Sri Ramachandra Institute of Higher Education & Research, Porur, Chennai, India;2. Department of Microbiology, Sri Ramachandra Institute of Higher Education & Research, Porur, Chennai, India;1. Department of Microbiology, Marmara University School of Medicine, Istanbul, Turkey;2. Department of Infectious Disease and Clinical Microbiology, Marmara University School of Medicine, Istanbul, Turkey;3. Department of Public Health, Marmara University School of Medicine, Istanbul, Turkey;1. Institute of Clinical Microbiology & Immunology, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, 110060, India;2. Department of Cardiology, Sir Ganga Ram Hospital Rajinder Nagar, New Delhi, 110060, India;1. Department of Microbiology, ESIC Medical College & Hospital, Sanathnagar, Hyderabad, India;2. Department of Microbiology, All India Institute of Medical Sciences, Gorakhpur, India;3. Department of Biochemistry, ESIC Medical College & Hospital, Sanathnagar, Hyderabad, India
Abstract:PurposeAntimicrobial resistance (AMR) is a serious threat to the humanity now a days. To prevent it, the first step is to know about our antibiotic practices. Audit is the first step in continuous quality improvement which intend to go ahead. Antibiotic stewardship involves appropriate antibiotic (empirical or definitive) at correct time in correct doses and frequency for appropriate duration.MethodWe conducted a retrospective study in intensive care unit at our tertiary care center of Bihar, India. Our aim was to know about empirical antibiotic we are prescribing in suspected sepsis patients and their rationality too. National treatment guidelines for infectious disease released by National Centre for Disease Control (NCDC) was taken as standard of care. We recorded demographic profile, SOFA (Sequential Organ Failure Assessment), APACHE II (Acute Physiology and Chronic Health Evaluation), antibiotic prescribed, final etiology of infection, and outcome of the patient and total ICU stay.ResultWe found that combination of two antibiotics were given in majority of patients (53%) and the third generation cephalosporin was the most commonly prescribed antibiotic. In our audit, rational combinations according to the antibiotic policies were given in 73.7% of patients. Appropriate doses of antibiotics were given in 89.5% of patients.ConclusionAudit is a mandatory exercise to provide quality care in the health care system.
Keywords:Antibiotic stewardship  Intensive care unit  Antibiotic resistance
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