ORIGINAL ARTICLE
Implementation of a Clinical Pharmacology-Centric Antimicrobial Stewardship Initiative within COVID-19 Intensive Care Units at a Leading Tertiary Care Referral Center in India
Nanda Gamad, Samiksha Bhattacharjee, Nusrat Shafiq*, Ashish Bhalla, Kajal K, Bhagat H, et al.
JASPI September 2024 / Volume 2 / Issue 3
Copyright: © Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0), which permits non-commercial use, sharing, and reproduction in any medium or format, provided the original author and source are credited, and no modifications or adaptations are made.
Gamad N, Bhattacharjee S, Shafiq N, et al. Implementation of a Clinical Pharmacology-Centric Antimicrobial Stewardship Initiative within COVID-19 Intensive Care Units at a Leading Tertiary Care Referral Center in India. JASPI. 2024;2(3):22-28. DOI: 10.62541/jaspi042
ABSTRACT
Background: The importance of antimicrobial stewardship during the COVID-19 pandemic remains underreported.
Methods: We prospectively audited antimicrobial use in COVID-19 ICUs of a tertiary care center from April 2021 to June 2021 during the delta wave of COVID-19 in India. Prospective audits and feedback (PAF) were conducted concurrently during case discussions on all days during this period. A summary of feedback, including empiric antibiotic rationality, de-escalation, etc., was mailed to all the treating physicians every day.
Results: 161 out of 183 patients (87.97%) were empirically prescribed antimicrobials in COVID ICUs, with an average of three antimicrobials per patient. The most commonly prescribed empiric antibiotic was piperacillin-tazobactam, followed by ceftriaxone and colistin. De-escalation was suggested in 45.2% of prescriptions, which were followed in 36.5% but delayed in around 16% of suggestions. The presence of multiple comorbidities with intubation and/or shock was the most common reason for initiating and continuing empirical antimicrobials. Around 29.8% of the patients on antimicrobials developed MDR infections, and Acinetobacter baumannii was the most common organism isolated, with an average length of stay of 20 (19.6 days).
Conclusion: Antimicrobial stewardship can play an essential role in minimizing the use of unnecessary antimicrobials in COVID-19 patients.
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Copyright © Author(s) 2024. JASPI- Journal of Antimicrobial Stewardship Practices and Infectious Diseases.