help button home button ClinMed NetPrints
HOME HELP FEEDBACK BROWSE ARTICLES BROWSE BY AUTHOR
Warning: This article has not yet been accepted for publication by a peer reviewed journal. It is presented here mainly for the benefit of fellow researchers. Casual readers should not act on its findings, and journalists should be wary of reporting them.

This Article
Right arrow Full Text
Services
Right arrow Similar articles in this netprints
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Shankar, R. P
Right arrow Articles by Brahmadathan, K. N
Right arrow Search for Related Content
PubMed
Right arrow Articles by Shankar, R. P
Right arrow Articles by Brahmadathan, K. N
Related Collections
Right arrow Drugs:
Pharmacology and toxicology

Right arrow Infectious Diseases:
Drugs: infections

Right arrow CLINICAL:
Medicine in Developing Countries

clinmed/2002050008v1 (July 26, 2002)
Contact author(s) for copyright information

Investigation of antimicrobial use pattern in the intensive treatment unit of a teaching hospital in western Nepal

Ravi P Shankar, Praveen Partha, Nagesh K Shenoy, and Kailash N Brahmadathan

Introduction: Inappropriate use of antimicrobials is of special importance in the intensive treatment unit because of the large number of drugs prescribed, the chance for drug errors and the likelihood of development of drug resistance. Methods: 297 inpatient records of patients admitted to the intensive treatment unit of the Manipal teaching hospital, a tertiary care hospital in Pokhara, western Nepal were studied to determine the prescribing frequency and rationality of use of antimicrobials. The patient outcome, the duration of stay in the intensive care unit and the age and sex distribution of the patients were also studied. Results: Mean SD drugs per patient was 3.45 1.78. 50.17% of the patients received an antimicrobial. 84.56% of the antimicrobials were used without obtaining bacteriological evidence of infection. The commonest organisms isolated on culture were Pseudomonas aeruginosa, Klebsiella pneumoniae, Streptococcus pneumoniae and Staphylococcus aureus. 28.86% of the antimicrobials were prescribed for lower respiratory tract infections based on the putative site of infection. 61.86% of the antimicrobials were prescribed by the parenteral route and mainly the older generation of antimicrobials were used. In 39 out of the 149 patients prescribed an antimicrobial the use was irrational. Conclusions: Prescriber education to improve prescribing patterns and regular auditing of antimicrobial prescriptions to prevent their irrational use as well as unnecessary cost to the patients are required. The high percentage of irrational use of antimicrobials raises concerns about the development and spread of drug resistance and this has to be addressed.





HOME HELP FEEDBACK BROWSE ARTICLES BROWSE BY AUTHOR