Keywords
Central India
Intensive care units
Point prevalence survey
Stewardship
Abstract
Introduction. Inappropriate use of antimicrobials is the primary driver of antimicrobial resistance, which threatens modern medicine. Monitoring antimicrobial consumption is the initial step for planning and guiding antimicrobial stewardship initiatives. This pilot study aimed to evaluate antimicrobial consumption patterns among adult and pediatric patients and to identify factors influencing antimicrobial use in the intensive care units (ICUs) of a tertiary care hospital in Central India.
Methods. This hybrid point-prevalence survey was conducted across five ICUs of a tertiary care hospital in March 2025. The survey included all ICU-admitted patients on the day of the survey. Antimicrobial prescription data, laboratory investigations, and clinical-demographic data were retrieved from medical records. The WHO Anatomical Therapeutic Chemical and WHO-AWaRe classification systems were used to categorize the antimicrobials used. Antibiotic consumption was evaluated using the Defined Daily Dose methodology, and factors associated with antimicrobial use were analyzed using descriptive statistics and logistic regression.
Results. Among 88 patients, 79 (89.77%) received at least one antimicrobial. Of 188 antimicrobials prescribed, antibacterials accounted for the highest consumption (96.3%). The most commonly prescribed antibiotics included cefotaxime, metronidazole, and meropenem. The highest (65%) consumption of antimicrobials was from the “Watch group”, with empirical therapy as the primary indication, accounting for 63.29% of prescriptions, of which 63.29% were appropriate. No significant differences were observed in consumption patterns between pediatric and adult patients.
Conclusion. The high consumption of antimicrobials in ICUs is predominantly from the Watch category, with higher use for empirical therapy, indicating an urgent need for robust antimicrobial and diagnostic stewardship.
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