Antibiotic Prescribing Practices in the Intensive Care Unit of a Nigerian Teaching Hospital.

Antibiotic prescribing practices in the intensive care unit

Abstract

Background:

Antibiotics are vital in the prevention and treatment of bacterial infections. However, prescribing practices often deviate from established guidelines with prolonged durations of surgical prophylaxis, redundant antibiotic combinations, and a significant reliance on broad-spectrum agents. This study seeks to determine the antibiotic prescribing practices in our teaching hospital.

Methods

This was a prospective, descriptive cross-sectional study of adult patients admitted into the ICU of the University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria. The study participants were critically ill patients between the ages of 6 months - 65 years who were admitted into the ICU. With the aid of a questionnaire, information such as age, sex, diagnosis, antibiotic prescription and regularity of administration, use of microbiological investigations and outcome of ICU care were extracted from the patients’ hospital files and recorded. Data from this study were summarized expressed as means, standard deviation, frequencies or proportions of the total. A p-value of less than 0.05 was considered statistically significant.

Results

A total of 128 ICU patients were enrolled into the study. One hundred and twenty four (96.88%) patients were prescribed antibiotics. Antibiotic prescription was for prophylactic reasons in 56 (45.16%) patients and therapeutic reasons in 68 (54.84%) patients. All antibiotic prescriptions were empirical. The most frequently prescribed antibiotic was ceftriaxone. The most frequently prescribed combination of antibiotics was Ceftriaxone/Metronidazole. There was no statistically significant difference in gender (0.7651) and age (p = 0.0775) between those who survived to ICU discharge and those who died. Prophylactic antibiotic prescription was associated with survival to ICU discharge compared to therapeutic prescription (p = 0.0018). 

Conclusion

Ceftriaxone was the primary empirical ICU antibiotic therapy employed while metronidazole is strategically used for anaerobic coverage. Critical care physicians favoured empirical therapy to the detriment of targeted therapy in this study.