ASSESSMENT OF AWARE-BASED ANTIBIOTIC CONSUMPTION AMONG ADULT ICU PATIENTS AT A TERTIARY CARE HOSPITAL: A PROSPECTIVE OBSERVATIONAL STUDY
DOI:
https://doi.org/10.69980/0w51kg61Keywords:
Antimicrobial stewardship, AWaRe classification, Antibiotic consumption, Intensive care unit, Defined daily doseAbstract
Background
Antimicrobial resistance (AMR) is a growing global health concern, particularly in intensive care units (ICUs), where broad-spectrum antibiotic use is common. The World Health Organization (WHO) introduced the AWaRe (Access, Watch, Reserve) classification to optimize antimicrobial stewardship and monitor antibiotic consumption patterns.
Aim
To estimate antibiotic consumption among adult ICU patients admitted to a tertiary care teaching hospital during January–December 2024 using the WHO AWaRe classification and Defined Daily Dose (DDD)/100 bed-days methodology.
Materials and Methods
A prospective observational study was conducted in adult ICUs of Government General Hospital (GGH), Guntur, from January to December 2024. Antibiotic consumption data were obtained from the central pharmacy and categorized according to the WHO AWaRe classification. Consumption was quantified using the Anatomical Therapeutic Chemical (ATC)/DDD methodology and expressed as DDD/100 bed-days. Monthly and annual trends in antimicrobial utilization were analyzed.
Results
The total antimicrobial consumption was 732.3 DDD/100 bed-days. Watch group antibiotics accounted for 563.8 DDD (77.0%), followed by Access antibiotics with 153.1 DDD (20.9%) and Reserve antibiotics with 15.4 DDD (2.1%). Ceftriaxone was the most consumed antibiotic (299.9 DDD/100 bed-days), followed by Amikacin (87.6 DDD/100 bed-days) and Piperacillin-Tazobactam (75.1 DDD/100 bed-days). Monthly antimicrobial consumption varied from 42.8 DDD/100 bed-days in October to 72.4 DDD/100 bed-days in July. Access antibiotic utilization remained substantially below the WHO target of ≥60%.
Conclusion
Watch category antibiotics dominated prescribing practices in adult ICUs, while Access antibiotic use remained considerably below WHO recommendations. Continuous antimicrobial stewardship interventions are necessary to optimize antibiotic utilization and reduce the risk of antimicrobial resistance.
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