Evaluating Antibiotic Utilization in Intensive Care Units Using WHO Defined Daily Dose and Drug Utilization 90% Methods

Abstract

It is essential to assess the drug utilization evaluation patterns of antimicrobials in the ICU to safeguard rational use of antibiotics. We aimed to evaluate the drug utilization patterns of antibiotics using World Health Organization (WHO) methodologies, namely Defined Daily Dose (DDD)/100 patient days and DU 90% in the ICU. We conducted a drug utilization evaluation study in three medicine intensive care units on a sample of 397 patients. We used World Health Organization- Anatomic Therapeutic Classification (ATC)/Defined Daily Dose (DDD) and Drug Utilization 90% methods to measure drug utilization. We classified the commonly used antibiotics into Access, Watch, and Reserve (AWaRe) category proposed by WHO. The average number of antibiotics per prescription was 2.14±1.28 and average duration of treatment with an antibiotic was 6.25 ± 3.37. The DDD/100 patient days for cefoperazone + sulbactam was 2.64. The drugs included in the DU90% segment, indicating the most often used antibiotics, were cefoperazone + sulbactam, ceftriaxone, cefpodoxime, azithromycin, piperacillin + tazobactam, amikacin, metronidazole, levofloxacin, meropenem, and cefixime. Seventy-two percent of antibiotics in DU90% segment fell into the ‘Watch’ category. Culture sensitivity tests were often not performed, and there was a heavy reliance on the use of antibiotics from the Watch group.

Keywords

• defined daily dose
• drug utilization 90%
• antibiotics
• antibiotic stewardship
• cephalosporins

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