Assessment of Antimicrobial Use Pattern in Paediatric Intensive care unit in tertiary care hospital Northern India


Background:  In India, antimicrobial resistance are getting increase day by day due to misuse of antimicrobial drugs or irrational prescription practice by Clinicians. After implementing so many guidelines by government but hence there is no control on antimicrobial resistance. Irrational prescribing of medicine results in increased morbidity and mortality as well as additional economic burden to health services. The aim of this study was to assess antimicrobial use pattern in Pediatric intensive care unit in tertiary care hospital. Methodology: This retrospective observational study was carried out in a 338-bedded multispecialty hospital for 4 months. Data was collected and analyzed as per World health Organization (WHO) and Indian Council of Medical Research (ICMR) guidelines. Results: A total of 52 patient’s case sheets and 34 (65.38%) patients were having antibiotics in their prescription. Febrile Seizure was a common clinical condition in which the antibiotics were prescribed in high percentage (20.5%). It was found that 21 (61.76%) prescription was mono-antibiotic prescription and 13 (38.23%) prescription was poly- antibiotic prescription. Among the mono-antibiotic prescription ceftriaxone was most commonly prescribed and in case of poly-antibiotic therapy combination of ceftriaxone and amikacin was mostly prescribed. Out of 48 antibiotics total 3 (6.25%) antibiotics were found inappropriate as per WHO guidelines and 45 (93.75%) antibiotic was prescribed appropriately. Conclusion:  It was found that antibiotics were prescribed frequently in most of the prescription in which mono-antibiotic therapy was preferred more over poly-antibiotic therapy. Sometimes physician have to choose antibiotic out of the guideline, in such cases antibiotic should be de-escalated based on culture reports and clinical condition of the patient within 48 hours. Hence, there is a need to promote rational use of antimicrobials, as their irrational use would lead to antimicrobial resistance.

Keywords: WHO, Indian Council of Medical Research, antibiotic, antimicrobial resistance.