Antimicrobial consumption in five adult intensive care units: a 33-month surveillance study.
Background
Estimating the baseline antimicrobial consumption is extremely important to monitor the impact of antimicrobial stewardship activities that aim to reduce the burden and cost of antimicrobial consumption.


Objectives
To quantify service-specific antimicrobial consumption using different metrics.


Methods
A surveillance study was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between October 2012 and June 2015 in five adult intensive care units (ICUs). Consumption data were collected manually on a daily basis by infection control practitioners. Data were presented as defined daily dose (DDD), days of therapy (DOT) per 1000 patient days, and frequency of daily consumption.


Results
A total of 43,970 DDDs and 46,940 DOTs were monitored during 54,116 patient-days. For the most frequently consumed antimicrobials, the consumption of carbapenems, piperacillin/tazobactam, vancomycin, and colistin (respectively) in all ICUs combined were 255.9, 134.3, 98.2, and 13.6 DDDs per 1000 patient-days and 235.7, 145.9, 129.5, and 117.5 DOTs per 1000 patient-days. For the frequency of daily consumption, carbapenems were the most frequently consumed antimicrobial group in medical/surgical, burn, and step-down ICUs while piperacillin/tazobactam was the most frequently consumed antimicrobial in neuro-surgical and cardio-thoracic ICUs.


Conclusion
High consumption of broad-spectrum antimicrobial agents such as meropenem and piperacillin/tazobactam is observed in multiple ICUs in a tertiary care hospital. Meropenem consumption is considerably higher than similar ICUs internationally. Future studies focusing on concurrent monitoring of antimicrobial resistance and identifying patient and physician characteristics associated with specific prescription patterns may help in improving judicious antimicrobial consumption.
['Balkhy|Hanan H|HH|', 'El-Saed|Aiman|A|', 'El-Metwally|Ashraf|A|', 'Arabi|Yaseen M|YM|', 'Aljohany|Sameera M|SM|', 'Al Zaibag|Muayed|M|', 'Baharoon|Salim|S|', 'Alothman|Adel F|AF|']
D000328:Adult D000900:Anti-Bacterial Agents D000073602:Antimicrobial Stewardship D015780:Carbapenems D003091:Colistin D003141:Communicable Diseases D003362:Cost-Benefit Analysis D004363:Drug Utilization D005260:Female D006801:Humans D007362:Intensive Care Units D008297:Male D000077731:Meropenem D008875:Middle Aged D000077725:Piperacillin, Tazobactam Drug Combination D011159:Population Surveillance D012529:Saudi Arabia D062606:Tertiary Care Centers D014640:Vancomycin D055815:Young Adult
Consumption Saudi Arabia Defined daily dose Days of therapy Antimicrobial agents Antimicrobial resistance