Profile of antimicrobial use in the intensive care unit of a public hospital

Abstract

Background: Inappropriate use of antimicrobials can lead to serious consequences such as insufficient therapeutic effect, adverse reactions, drug dependence, increased bacterial resistance, increased morbidity, mortality, and consequently, attention to health. Objective: to evaluate and quantify the use of antimicrobials used in the intensive care unit (ICU) of a Public Hospital in relation to the Anatomical Therapeutic Chemical/Daily Definite Dose (ATC/DDD) methodology. Methods : a cross-sectional, descriptive, quantitative and retrospective study was carried out between January 1 and March 31, 2016. The calculation of the DDD per 100 bed-days defined by Gomes and Reis was used. Results: in the study of DDD/100- day observation greater than the findings in the literature, with values for Meropenem (77.71), Polymixin E (57.89), Linezolid (20.01), Teicoplanin (19.85), Cefepime (19,06), Polymyxin B (17,54), Micafungin (16,19), Tigecycline (15,55) and Amikacin (14,12). The differences in DDD/100-day-days found in the literature show: a local epidemiology; Microbiological profile of each hospital; The period studied; The implanted clinical protocols; More serious infections as well as bacterial resistance in the hospital environment. Conclusions: the high use of meropenem may have been influenced by the severity of the patient’s condition as well as the prescription of empirical therapy. The others more consumed were used in associations in the therapy to reach the clinical and therapeutic improvement of the patient. Therefore, it is important to encourage new research by correlating DDD with the microbiological profile of patients, and pharmacovigilance and pharmacoeconomic studies.