Antibiotic Consumption in Intensive Care Units in some Hospitals in Sana’a City

Abstract

Background: Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, currently there is no system in Sana'a city for recording and reporting on antibiotic consumption. Our study is the first of its kind to look at the antibiotic usage in an ICU in Sana’a, Yemen using DDD and DOT methods.
Objectives: to estimate the antimicrobial consumption in hospitals” ICUs at Sana'a city.
Methods: A retrospective study on data from the ICU register .The study was carried out on admitted patients of five ICUs of main hospitals at 2020. Antimicrobial consumption data were mostly collected manually. Data were analyzed and presented as defined daily dose (DDD) and days of therapy (DOT) per1000 patient days.
Results: A total of 1970 patients were included in this study. In this study we found the total consumption of antibiotics in ICUs were high of by DDD 18017.91 DDD per 1000 patient and by DOT 17448.73 DOT per 1000 patient-days. The study results discovered that ceftriaxone, vancomycin, and meropenem were the most average consumed using both DDD and DOT methods among ICU patients where results by DDDs per 1000 admission were 2479.23, 2124.55 and 1830.54 respectively and by DOTs per1000 patient-days were 2112.69, 2055.33 and 1890.86. Based on therapeutic/pharmacological subgroups in measuring consumption using DDD and DOT, the most consumption were cephalosporins (3882 DDD per 1000 patient and 4227.41DOTs per 1000 patient-days), carbapenems (2987 DDD per 1000 patient and 2888.83DOTs per 1000 patient-days) and quinolones (2900 DDD per 1000 patient per days and2660.41DOTs per 1000 patient-days). The highest amount of antibiotics consumption among WHO AWaRe classification was for "watch" group of 26267.4 DDDs and 14674.5 DDDs per 1000 patient per day.
Conclusion: High consumption of antimicrobial agents such as ceftriaxone, vancomycin and meropenem is observed in ICUs of a five hospitals. The findings highlighted the urgent need for an effective antimicrobial stewardship program in these hospitals with focusing on ICUs specific- antimicrobial consumption. The study results can be used as base before designing any intervention aiming to optimize antibiotics utilization in hospitals ICUs. Future studies focusing on concurrent monitoring of antimicrobial resistance with specific prescription patterns may help in improving judicious antimicrobial consumption.