Use of antibiotics by ICU patients in a public hospital in Northeastern Brazil (2021-2022)

Vollständiger Abstract

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Background: Inadequate use of antibiotics in Intensive Care Units (ICUs), particularly without consideration of microbiological culture results, has a direct impact on healthcare-associated infections (HAIs), multidrug resistance, hospital costs, and clinical outcomes. This study aimed to analyze antibiotic use among patients admitted to the ICU of a public regional hospital in northeastern Brazil, during the implementation of an Antimicrobial Stewardship Program (ASP). Methods: Data were obtained from electronic medical records of patients admitted between March 2021 and December 2022. Collected variables included demographic characteristics and ICU-related clinical data. Eligible patients were aged 18 years or older and had remained in the general ICU for at least 72 hours. Statistical analyses were performed using R Core Team software. Results: Patients admitted to the ICU (95.4%) received antibiotics during their hospital stay. The most frequently prescribed antimicrobials was ceftriaxone (229/394;58.1%). Antimicrobial prescriptions were primarily based on clinical symptoms and laboratorial results based on the physician’s judgment at the bedside. Conclusions: An excessive use of antibiotics in the ICU was related to lack of microbiology support and the absence of a fully implemented and effective ASP. These determinants may contribute to AMR and highlight the urgent need for strengthened stewardship strategies.