Profile and quality of antimicrobial use in adult intensive care units

Abstract

Objective: To describe the profile and determine the quality of antimicrobial use in adult intensive care units (ICUs). Methods: Cross-sectional, descriptive study, carried out in the ICUs of a regional reference public hospital. Patients admitted to the ICUs between October and December 2020, who used antimicrobials during hospitalization or up to 24 hours before admission, aged ≥18 years, were evaluated. A standard form and quality indicators adapted from Van den Bosch CMA, et al. (2015) were used. Frequencies (absolute and relative), means and standard deviation were calculated using SPSS 21.0 software. The study was approved by the Research Ethics Committee. Results: We identified 426 antimicrobials in use by 171 patients, highlighting third-generation cephalosporins (23.2%), penicillins + beta-lactamase inhibitors (17.8%), carbapenems (12.9%) and macrolides (12.2%). Among 67 microorganisms identified in cultures, 64.1% corresponded to critical priority pathogens. The quality of therapy indicators showed more frequent inadequacy in relation to discontinuing empirical therapy, changing the scheme to targeted therapy, followed by requesting blood culture and collection of suspicious sites within 24 hours of starting empirical therapy. Conclusion: There was a predominance of use of beta-lactams and carbapenems and a high number of critical pathogens.