title: Antimicrobial usage in an intensive care unit: a prospective analysis.
abstract: Antimicrobial therapies in the Intensive Care Unit (ICU) need to be appropriate in both their antimicrobial cover and duration. We performed a prospective observational study of admissions to our semi-closed ICU over a three-month period and recorded the indications for antimicrobial therapy, agents used, duration of use, changes in therapy and reasons for changes in therapy. A change in therapy was defined as the initiation or discontinuation of an antimicrobial agent. There were 51 patients admitted during the three-month study period and all received antimicrobial therapy. There were 135 changes in antimicrobial therapy. 89 (66%) were made by the ICU team and 32 (24%) were made by the primary team. Changes were made due to a deterioration or lack of clinical response in 41 (30%) cases, due to the completion of prescribed course in 36 (27%) cases, and in response to a sensitivity result in 25 (19%) cases. Prophylactic antibiotic courses (n=24) were of a duration greater than 24 hours in 15 (63%) instances. In conclusion, the majority of changes in antimicrobial therapy were not culture-based and the duration of surgical prophylaxis was in excess of current recommended guidelines.
authors: Department of Anaesthesia & Intensive Care Medicine, Mercy University Hospital, Grenville Place, Cork. iancm25@hotmail.com
authors: I
authors: I
authors: Conrick-Martin
authors: A
authors: A
authors: Buckley
authors: J
authors: J
authors: Cooke
authors: F
authors: F
authors: O'Riordan
authors: J
authors: J
authors: Cahill
authors: D
authors: D
authors: O'Croinin
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D017723:Drug Utilization Review / Q000379:methods*; D005260:Female; D006801:Humans; D007239:Infections / Q000188:drug therapy*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents