Antimicrobial utilisation in 37 Australian and New Zealand intensive care units

• Published in: Anaesthesia and intensive care 2011-03, Vol.39 (2), p.231-237
• Main Authors: DULHUNTY, J. M, PATERSON, D, WEBB, S. A. R, LIPMAN, J
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Aged; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Anti-infective agents; Antibiotic Prophylaxis - methods; Australia; Bacterial Infections - drug therapy; Bacterial Infections - prevention & control; Biological and medical sciences; Child; Dosage and administration; Dose-Response Relationship, Drug; Drug Administration Routes; Drug Administration Schedule; Female; Humans; Infection control; Intensive care units; Intensive Care Units - statistics & numerical data; Male; Medical sciences; Methods; Middle Aged; New Zealand; Services
• ISSN: 0310-057X; 1448-0271
• DOI: 10.1177/0310057x1103900212

This multi-centre point prevalence study reports on antimicrobial dosing patterns, including dose, mode of administration and type of infection, in 37 Australian and New Zealand intensive care units. Of 422 patients admitted to an intensive care unit on 8 May 2007, 195 patients (46%) received antimicrobial treatment, 123 patients (29%) received no antimicrobials and 104 patients (25%) received prophylactic antimicrobials only. Dosing data were available for 331 antimicrobials used to treat 225 infections in 193 patients. Respiratory (40%), abdominal (13%) and blood stream (12%) infections were most common. For adult patients, ticarcillin/clavulanate (23% or 40/177), meropenem (20% or 35/177) and vancomycin (18% or 32/177) were the most frequently used antibiotics; vancomycin was most commonly used in children (31% or 5/16). The majority of antimicrobials were administered as bolus doses or infusions of less than two hours (98% or 317/323); only six patients received extended or continuous infusions. The mode of administration was unknown in eight cases (4.1%). The total defined daily dose for adult patients receiving antimicrobial therapy was 2051 defined daily doses per 1000 patient days. Our results confirm that the use of continuous infusions remains rare, despite increased interest in continuous infusions for time-dependent antibiotics.