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Drug Utilization Pattern in the Intensive Care Unit of a Tertiary Care Hospital

From the Departments of Pharmacology (S. Biswal, S. Malhotra, P. Pandhi) and Anesthesiology (P. Mishra, G. D. Puri), Postgraduate Institute of Medical Education & Research, Chandigarh, India. S. Malhotra and P. Pandhi are Fellows of the American College of Clinical Pharmacology (FCP).

The authors studied the factors affecting drug use pattern, cost of therapy, and the association between the pattern of drug use and survival as well as the duration of stay in a prospective, observational study in an intensive care unit between February and May 2005. Data were collected regarding drugs used, severity of the disease, and their outcome. The mean ± SD of the Acute Physiology and Chronic Health Evaluation (APACHE III) and Glasgow Coma Scale (GCS) scores of 84 patients were 52.2 ± 19.4 and 7.5 ± 2.4, respectively. Although the mean number of drugs at the time of admission to the intensive care unit was 5.3, it increased to 12.9 on the first day and 22.2 during the entire stay. More than 50% of the average expenditure on drugs and nutrition was accounted by antibiotics. Requirement of insulin or inotropes signified an adverse outcome on mortality (odds ratios of 3.43 and 8.44, respectively). In conclusion, there is a tremendous impact of antibiotic use on the cost of therapy in the intensive care unit. The requirement of certain drugs such as insulin and inotropes is of prognostic significance.

Key Words: Drug utilization • pattern • ICU

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