Antibiotic prescribing in an intensive care unit: findings from a public Malaysian setting

Rozali, Mohammad Azrai and Ab Rahman, Norny Syafinaz and Sulaiman, Helmi and Abd Rahman, Nurul and Atiya, Nadia and Wan Mat, Wan Rahiza and Jamaluddin, Mohd Fadhil and Mazlan, Muhd Zulfakar and Mat Nor, Mohd Basri and Abdul Aziz, Mohd Hafiz and Hasan, Mohd Shahnaz (2020) Antibiotic prescribing in an intensive care unit: findings from a public Malaysian setting. In: International Conference on Pharmaceutical Research and Pharmacy Practice cum 14th IIUM-MPS Pharmacy Scientific Conference (ICPRP 2019), 19th - 20th October 2019, Hotel Istana Kuala Lumpur.

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Abstract

Introduction: Data on antibiotic prescribing together with its knowledge and perception in Malaysian ICU is lacking. Objectives: To explore knowledge, perception, and antibiotic prescribing among specialists and advanced trainees in Malaysian ICU. Materials and Methods: A cross-sectional survey was employed which consisted of three sections namely knowledge, perception, and practice. Three case vignettes consisted of hospital-acquired pneumonia (HAP), infected necrotising pancreatitis (INP), and catheter-related bloodstream infection (CRBSI) were presented in the practice section to gather information on prescribing practice. Results: About 868 respondents were approached but only 104 responded (12.0% response rate). Seven different classes of antibiotics giving a total of 390 were empirically prescribed for the three cases combined. Antibiotic prescribing compliance which indicates correct choice of antibiotics and dosing were 66.3%, 56.7%, and 19.2% for HAI, INP, and CRBSI respectively. In perception, 97.2% and 85.6% of respondents conceded that antibiotic concentration is inadequate, and that dosing be based on MIC respectively. Majority (94.2%) perceived that antibiotic dosing follows PK/PD profile but only half (50.9%) agreed that therapeutic drug monitoring be routinely performed. Comprehension on antibiotics showed that all respondents acknowledged PK/PD profile of antibiotics but only 64.4% able to correlate given antibiotic with their respective PK/PD. Only 13.5% of respondents able to identify the best PD approach for Î-lactam antibiotics in sepsis patients. Conclusion: Antibiotic prescribing was somewhat appropriate in Malaysian ICU. Prolong therapy and inadequate coverage are the hallmark need to be considered especially in CRBSI. Clinicians are conversant with available antibiotics but apprehension in its PK/PD is scant

Item Type:	Conference or Workshop Item (Slide Presentation)
Additional Information:	5608/85310
Uncontrolled Keywords:	antibiotics, survey, beta-lactam
Subjects:	R Medicine > RC Internal medicine > RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care Kulliyyah of Pharmacy Kulliyyah of Pharmacy > Department of Pharmacy Practice
Depositing User:	Dr. Mohd Basri Mat Nor
Date Deposited:	14 Dec 2020 08:58
Last Modified:	14 Dec 2020 08:58
URI:	http://irep.iium.edu.my/id/eprint/85310

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