Evaluation of the Appropriateness of Antimicrobial Drug Dosages in Intensive Care Unit Patients

Abstract

The purpose of this study was to investigate the factors that required dose adjustments of antimicrobial drugs in intensive care unit (ICU) patients and to identify the drugs that required the most dose adjustments. The current prospective study was conducted in the reanimation ICU with 26-bed capacity of a university-affiliated hospital from September to December 2022. Two clinical pharmacists on duty examined patients’ antimicrobial drug dosages daily. The acceptance status of the recommendations and the patients’ demographic information were recorded. The study involved 133 ICU patients, and antimicrobial drug recommendations were made for 48 patients, 31 (64.6%) of whom were male. The median (IQR) age of the 48 patients was 67 (54–77). The count of recommendations was 94, and the acceptance rate was 100%. The recommendation rates were as follows: 71.3% for renal function, 11.7% for presence of continuous renal replacement therapy, 10.6% for indication, 4.3% for body weight, and 2.1% for loading dose. The top 3 drugs for which recommendations were made the most were colistin (21.3%), meropenem (18.1%), and piperacillin-tazobactam (12.8%). The most troublesome drug was colistin, which is frequently used to treat Acinetobacter pneumonia. Clinical pharmacist and physician collaboration may help rationalize ICU antimicrobial drug use.

Keywords

• antimicrobial drugs
• clinical pharmacist
• colistin
• intensive care unit
• meropenem

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