Drug-use patterns in an intensive care unit of a hospital in Iran: an observational prospective study

Abstract

Abstract Objectives The aim of this study was to evaluate drug-use patterns, investigate the factors influencing patient outcome, and determine the cost of drugs utilized in the intensive care unit (ICU). Methods In an observational prospective study, drug prescriptions for 113 patients admitted to the ICU of a hospital in Iran were recorded. The cost of drugs in ICU and the entire hospital was also calculated. Descriptive analysis and logistic regression were used to present the results. Key findings The mean age of patients was 50.3 years (SD = 20.4). The average ICU stay was 6 days. The mean length of stay was significantly lower in surgical patients compared to medical patients (odds ratio (OR) = 0.91, 95% confidence interval (CI) 0.84–0.97). Mortality rate was significantly higher among medical patients (OR = 10.5, 95% CI 3.7–29.8). There was a significant positive association between the total number of prescribed drugs or antibiotics received by patients and mortality. Patients received an average of 8.2 drugs at admission, 10.1 drugs during the first 24 h and an average of 14.6 drugs over their entire stay at the ICU. Among drug groups, antibiotics and sedatives were most ordered drugs in ICU. Conclusions Antibiotics are responsible for the majority of ICU drug costs. Appropriate selection of antibiotics in terms of type, dose and duration of therapy could tremendously reduce the expenses in hospitals without negatively influencing the quality of healthcare.