Evaluating initial antimicrobial use in an adult intensive care unit at an academic teaching hospital in Pretoria, South Africa

Abstract

Antimicrobial resistance is increasing globally. It is estimated that in hospitals around the world 50% of antimicrobial usage is either unnecessary or inappropriate. The study aimed to explore factors surrounding initially prescribed antibiotics and direct medicine related costs in the adult Medical Intensive Care Unit (MICU), at Steve Biko Academic Hospital (SBAH). A clinically trained pharmacist was included as part of the multi-disciplinary team and evaluated antibiotics prescribed after admission. These were considered as the initial course of antibiotics. The antimicrobial agents that the patient was admitted with were documented and are referred to as “antibiotics prior to review”. Just less than half of the patients, 23 (44.2%; n = 52) were initiated on antibiotics on the first day of admission to the MICU. The majority of antibiotics 46 (60.5%) were prescribed appropriately during the study period. The total cost of initial antibiotic use for the treatment period during the study was R209 140.40, with an average cost of R31 240.77 per day for all initial antibiotics. A coordinated effort from the infectious diseases specialist and clinical pharmacist within the multi-disciplinary team, assisted in appropriate prescribing of antibiotics to patients that were admitted to the MICU