ABUTH Pharma Journal (2023) · 2023
Odiba et al.
Introduction: Antibiotics continue to be widely prescribed in critically ill patients (CIP), and they form a significant proportion of the total drugs consumed in the intensive care unit (ICU) and medical emergency unit (MEU). However, there is growing evidence that over use of antibiotics in CIP can translate into adverse patient outcomes and increased mortality. Objective: The aim was to determine the antibiotic prescribing pattern in patients admitted at the ICU and MEU of a tertiary health care facility in northern Nigeria. Methods: A retrospective and descriptive study using structured proforma to obtain information from prescription order forms and treatment sheets of patient admitted to the ICU and MEU between the periods of January to December 2021. Data obtained include patients' demographics and World Health Organization (WHO) drug use (prescribing and facility) indicators. Data were analyzed using descriptive statistics and results presented as frequencies and percentages. Results: A total of 213 prescriptions were analyzed. All encounters had 1104 drugs with an average of 5 medicines per prescription and 27.7% were antibiotics with 73.8% prescribed by their generic names. All the antibiotics (100%) were prescribed from Essential Medicine List and hospital formulary. Cephalosporins (31%) and nitroimidazoles (23%) ranked highest amongst classes of prescribed antibiotics. Parenteral antibiotic prescriptions were 86% in ICU and 40% in MEU respectively. Conclusion: We observed a moderate compliance with the WHO standards in antibiotic prescribing pattern in critically ill patients. We recommend that interventions be made and more emphasis placed on the need to promote rational antibiotic prescribing in order to reduce the burden of antibiotic resistance and its negative impact on health and economy of individuals and the society.
Volume: Vol. 1
Issue: No. 1
Pages: pp. 56–63
Year: 2023
Antibiotics make up a large share of medicines used in intensive care and emergency settings, but overuse contributes to resistance and worse patient outcomes, making prescribing pattern audits important.
A retrospective review of 213 prescriptions from the ICU and Medical Emergency Unit of a tertiary hospital (January–December 2021) assessed prescribing against WHO drug-use indicators.
Encounters averaged 5 drugs per prescription — well above the WHO benchmark of 1.6–1.8 — with 27.7% of drugs being antibiotics, 73.8% prescribed generically, and 100% drawn from the essential medicines list. Cephalosporins (31%) and nitroimidazoles (23%) were the most-prescribed antibiotic classes. Parenteral antibiotics dominated in the ICU (86%) while oral antibiotics were more common in the MEU (53%).
Prescribing showed moderate compliance with WHO standards. Interventions to promote more rational antibiotic prescribing are recommended to curb resistance and its costs to patients and the health system.