DRUG UTILIZATION STUDY IN TRAUMA INTENSIVE CARE UNIT
DOI:
https://doi.org/10.22159/ajpcr.2022.v15i6.44100Keywords:
Trauma, TICU, Head injury, AntibioticAbstract
Objective: Trauma is defined as major public health problem worldwide and associated with significant morbidity and mortality both in developed and developing countries and to study prescription pattern in TICU among head trauma patients.
Methods: The study was conducted in Trauma Intensive Care Unit of Department of Surgery in a Tertiary Care Hospital. This was a prospective, observational study done at a Tertiary Care Teaching Hospital. A total of 637 patients enrolled in the present study with fulfilling inclusion and exclusion criteria. Patient’s data recorded in case report form and analyzed to study the prescription pattern.
Results: A total of 637 cases were enrolled in this study. Trauma was more common in 499 (78.34%) male followed by 138 (21.66%) female. The average duration of stay in TICU was 3.62±1.38 days. In this study, mortality rate in study was 17.27 %. In the current study, the total numbers of drugs prescribed per prescription in TICU are most commonly between 5 and 8 (55.26%) drugs followed by between 9 and 12 drugs were 37.83%. The present study states that the most common prescribed drugs used were ranitidine (100%) followed by ondansetron (89.64%). Among antimicrobials cephalosporins were most commonly used ceftriaxone (31.08%) and cefotaxime (27.63%).
Conclusions: The aim of study is monitoring and evaluation of the prescribers as well as recommends necessary modifications to achieve rational medical care. Study outcomes suggesting that admission to TICU is more in middle age group with mean age of 40.2 years. Average numbers of drugs prescribed were 8.76 drugs per patients which shows the trends of polypharmacy in the prescriptions.
Downloads
References
Wafi ZA. Drug utilization at SKIMS-A tertiary care hospital. JK Pract 2013;18:35-40.
Kasabe P, Jaykar R, Patil PL. Clinical profile of chest injury a prospective observational study. Int Surg J 2016;3:1372-8. doi: 10.18203/2349-2902.isj20162714
Chalya PL, Gilyoma JM, Dass RM, Mchembe MD, Matasha M, Mabula JB, et al. Trauma admissions to the intensive care unit at a reference hospital in North Western Tanzania. Scand J Trauma Resusc Emerg Med 2011;19:61.
Substance Abuse and Mental Health Services Administration, Trauma-Informed Care in Behavioral Health Services. Treatment Improvement Protocol (TIP) Series 57. HHS Publication No. (SMA) 13-4801. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2014. p. 59-89.
Minei JP, Schmicker RH, Kerby JD, Stiell IG, Schreiber MA, Bulger E, et al. Severe traumatic injury: Regional variation in incidence and outcome. Ann Surg 2010;252:149-57. doi: 10.1097/ SLA.0b013e3181df0401, PMID 20531005
Al-Zakwani I, Al-Thuhli M, Al-Hashim A, Al Balushi KA. Drug utilization pattern in an intensive care unit at a tertiary care teaching hospital in Oman. Asian J Pharm Clin Res 2017;10:194-7. doi: 10.22159/ajpcr.2017.v10i2.15148
Ebrahimzadeh MA, Shokrzadeh M, Ramezani A. Utilization pattern of antibiotics in different wards of specialized Sari Emam university hospital in Iran. Pak J Biol Sci 2008;11:275-9. doi: 10.3923/ pjbs.2008.275.279, PMID 18817203
Dasta JF. Drug use in a surgical intensive care unit. Drug Intell Clin Pharm 1986;20:752-6. doi: 10.1177/106002808602001002, PMID 3769762
Bobek MB, Hoffman-Hogg L, Bair N, Slomka J, Mion LC, Arroliga AC. Utilization patterns, relative costs, and length of stay following adoption of MICU sedation guidelines. Formulary 2001;36:664.
Centers for Disease Control and Prevention. WISQARS Years of Potential Life Lost (YPLL) Report, 1999 and Later. United States: National Center for Injury Prevention and Control; 2017. Available from: https://www.webappa.cdc.gov/sasweb/ncipc/ypll.html
Ministry of Road Transport and Highways (MoRTH). Basic Road Statistics of India Government of India Ministry of Road Transport and Highways Transport Research Wing, New Delhi; 2008.
MoRTH. Road Accidents in India 2012. Ministry of Road Transport and Highways. New Delhi: Government of India; 2012.
MoRTH, GoI. Road Transport Year Book 2011-12. Ministry of Road Transport and Highways. New Delhi: Government of India; 2012.
Gopalakrishnan S. A public health perspective of road traffic accidents. J Fam Med Prim Care 2012;1:144-50. doi: 10.4103/2249-4863.104987, PMID 24479025
Shah K, Pirie S, Compton L, McAlister V, Church B, Kao R. Utilization profile of the trauma intensive care unit at the role 3 multinational medical unit at Kandahar airfield between May 1 and Oct. 15, 2009. Can J Surg 2011;54:130-4. doi: 10.1503/cjs.006611, PMID 22099326
Claridge JA, Pang P, Leukhardt WH, Golob JF, Carter JW, Fadlalla AM. Critical analysis of empiric antibiotic utilization: Establishing benchmarks. Surg Infect (Larchmt) 2010;11:125-31. doi: 10.1089/ sur.2009.047, PMID 20210653
Böhmer AB, Just KS, Lefering R, Paffrath T, Bouillon B, Joppich R, et al. Factors influencing lengths of stay in the intensive care unit for surviving trauma patients: A retrospective analysis of 30,157 cases. Crit Care 2014;18:143. doi: 10.1186/cc13976, PMID 25001201
Brattström O, Granath F, Rossi P, Oldner A. Early predictors of morbidity and mortality in trauma patients treated in the intensive care unit. Acta Anaesthesiol Scand 2010;54:1007-17. doi: 10.1111/j.1399- 6576.2010.02266.x, PMID 20626360
Sardinha DS, De Sousa RM, Nogueira Lde S, Damiani LP. Risk factors for the mortality of trauma victims in the intensive care unit. Intensive Crit Care Nurs 2015;31:76-82. doi: 10.1016/j.iccn.2014.10.008, PMID 25599997
Ulvik A, Wentzel-Larsen T, Flaatten H. Trauma patients in the intensive care unit: Short-and long-term survival and predictors of 30-day mortality. Acta Anaesthesiol Scand 2007;51:171-7. doi: 10.1111/j.1399- 6576.2006.01207.x
Boucher B, Kuhl D. Antimicrobials are most commonly used in a trauma intensive care unit. Am J Hosp Pharm 1990;47:805-10.
Patanwala AE, Amini R, Hays DP, Rosen P. Antiemeticztherapy for nausea and vomiting in the emergency department. J Emerg Med 2010;39:330-6.
Stollman N, Metz DC. Pathophysiology and prophylaxis of stress ulcer in intensive care unit patients. J Crit Care 2005;20:35-45.
Spirt MJ. Stress-related mucosal disease: Risk factors and prophylactic therapy. Clin Ther 2004;26:197-213.
Armstrong TA, Coursin DB, Devlin J, Duke JS, Fish D, Gonzalez ER, et al. ASHP therapeutic guidelines on stress ulcer prophylaxis. Am J Heal Pharm 1999;56:347-79.
Cook DJ, Fuller HD, Guyatt GH, Marshall JC, Leasa D, Hall R, et al. Risk factors for gastrointestinal bleeding in critically ill patients. N Engl J Med 1994;330:377-81.
Spirt MJ, Stanley S. Update on stress ulcer prophylaxis in critically ill patients. Crit Care Nurse 2006;26:18-28.
Ferry B, DeCastro A. Concussion. Treasure Island, FL: StatPearls. 2019.
Khairat A, Waseem M. Epidural Hematoma. Treasure Island, FL: StatPearls; 2019.
Mamatha V, Parashivamurthy BM, Suneetha DK. Study of drug utilization pattern in emergency medicine ward at a tertiary care teaching hospital. Int J Basic Clin Pharmacol 2017;6:868.
Gupta R. Drug prescribing pattern in Intensive Care Unit (ICU) in a tertiary care teaching hospital in central India. Int J Pharma Bio Sci 2015;6:P325-9.
Drupad HS, Nagabushan H, Prakash GM. Prospective and observational study of antimicrobial drug utilization in medical intensive care unit in a tertiary care teaching hospital. Int J Pharmacol Res 2016;6:13-7.
John LJ, Devi P, Guido G. Drug utilization study of antimicrobial agents in medical intensive care unit of a tertiary care hospital. Asian J Pharm Clin Res 2011;4:81-4.
Dubey AK, Mishra P, Deshpande, Shankar PR, Partha P. Intensive care unit drug utilization in a teaching hospital in Nepal. Kathmandu Univ Med J (KUMJ) 2005;3:130-7.
Biswal S, Mishra P, Malhotra S, Puri GD, Pandhi P. Drug utilization pattern in the intensive care unit of a tertiary care hospital. J Clin Pharmacol 2006;46:945-51.
Published
How to Cite
Issue
Section
Copyright (c) 2022 Nitin Hivale, Madhuri Kulkarni, Shrikant Lahamate
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
