(123) Evaluation of Antimicrobial Stewardship Metrics in Medical Intensive Care Unit: A Prospective Interventional Study

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1168

Presenting Author(s)

Rekha B
– Rekha B, Mysore, Karnataka, India

Co-Author(s)

Ramesh Madhan, PhD
– Professor, JSS College of Pharmacy, Mysore, India
Chalasani Sri Harsha, MPharm
– JSS College of Pharmacy, Dept of Pharmacy Practice, JSS College of Pharmacy, Mysuru, Karnataka, India
Jehath M. Syed
– JSS College of Pharmacy, Mysuru, Karnataka, India
Subhash Chandra BJ
– JSS Medical College & Hospital, Karnataka, India
Sumana M N
– JSS Medical College, Mysuru, India

Background: Antibiotic stewardship programs (ASP) are implemented to ensure appropriate use of antimicrobial therapy. To track the impact of the ASP, quality metrics are used, which aids in evaluating the success of the ASP and also identify the areas of improvement.

Objectives: To evaluate the antimicrobial stewardship metrics amongst the patients admitted to medical intensive care unit (MICU)

Methods: A prospective interventional study is being carried out in the MICU tertiary care teaching hospital for a period of nine months. All patients of any gender aged ≥ 18 years admitted to MICU receiving at least one antibiotic are being included in the study. The antimicrobial metrics- Defined Daily Dose (DDD), Days of Therapy (DOT), and Length of Therapy (LOT) are calculated to quantify the antibiotic use. Wilcoxon signed-rank test was used to compare DDD vs DOT values. The data obtained is assessed categorically.

Results: The interim study results show a total of 185 patients with admitted to the MCU over two months of the study. A total of 60 patients of which [35 (58.3%)] were males and [25 (41.7%)] were females who received at least one antibiotic were enrolled into the study. The mean age was 57.6 ± 19.8 years. The average length of stay was found to be 8.53 days. A total of 26 [(43.3%)] patients received definite therapy after obtaining culture report. The mean of total antibacterial drugs used is measured by the number of DDDs per 1000 patient days and the number of DOTs per 1000 patient days was found to be 814.5 ± 1273 and 765.6 ± 1028.3, respectively. In the 16 most commonly used antibacterial drugs the difference between DDDs and DOTs was major in [9 (56.25%)], moderate in [2 (12.5%)], and minor in [5 (31.25%)]. The LOT was found to be 8000 LOT per 1000 patient days.

Conclusions: A clinical pharmacist involved in tracking and reporting the antimicrobial use and outcomes is important to evaluate the success of the antimicrobial stewardship program and also identify the areas of improvement.