Professional paper
Antibiotic consumption and the prevalence of resistant microorganisms in the intensive care unit
Katarina Žeravica
orcid.org/0000-0002-4957-8570
; School of Medicine Osijek, University Josip Juraj Strossmayer, Osijek
Dinko Paulić
orcid.org/0000-0001-9890-2755
; Department for Microbiology, Institute of Public Health Osijek-baranja county
Dubravka Ivić
; School of Medicine Osijek, University Josip Juraj Strossmayer, Osijek, Department for Intensive Care medicine, Clinical Hospital Centre Osijek
Abstract
Objectives: To determine the extent to which antimicrobial drugs are consumed as well as qualitative features of antimicrobial drugs in the intensive care unit and to determine whether the manner in which these drugs are prescribed and consumed has any effect on the prevalence of bacterial resistance.
Study design: Across sectional study.
Participants and methods: The participants were patients treated in the intensive care unit of the Clinic for Anaesthesiology and Intensive Care in the Clinical Hospital Centre Osijek during 2015 and 2016. The inclusion criteria was the use of antimicrobial drug regardless of clinical indication. Relevant data about qualitative and quantitative aspect of consumption of drugs and the prevalence of resistant bacteria was collected from medical history of clinical diagnosis and microbiology protocols.
Results: During the observation period, 1 646 patients were treated and 7819 patient days were achieved. The majority of patients (88.3 %) received antimicrobial drugs even in the absence of infection (70 %). Approximately 19.1 % of the patients were diagnosed with the latter at the moment of admission. From 3300 prescribed antimicrobial drugs, 60 % were intended for prophylaxis or pre-emptive therapy, while 28.1 % were used for the treatment of established infection.
The most commonly prescribed drugs were amoxicilin with clavulanic
acid, metronidazole, gentamicin, and colistin from the list of reserve
antibiotics. Resistant bacteria that was most commonly isolated
were Acinetobacter baumannii, Klebsiella pneumoniae
and methicilin-resistant Staphylococcus aureus.
Conclusion: Almost 90 % of patients were given antimicrobial
drugs during their stay in the intensive care unit. More than two
thirds of patients received medications prophylactically or preemptively
even though the infection was absent. Amoxicilin with calvulanic acid, metronidazole and gentamicin were prescribed very often in prophylaxis or treatment, while reserve antibiotics were intended for the treatment of infection with resistant agents. The obtained results do not indicate a connection between the consumption of antimicrobial drugs and the appearance of bacterial resistance.
Keywords
antimicrobial drugs; consumption; prescription; resistant bacteria; intensive care
Hrčak ID:
216061
URI
Publication date:
22.1.2019.
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