Pattern of Antibiotics Prescription and alignment with antibiotic susceptibility test results in The Intensive Care Unit in the Eastern Region of Saudi Arabia

Abstract

BACKGROUND: The rising prevalence of multi-drug-resistant bacteria (MDRB) poses a significant challenge, particularly in intensive care units (ICUs), requiring strategic interventions to combat its impact. poses significant challenges in intensive care units (ICUs). In Saudi Arabia, limited data exist regarding MDRB prevalence and antibiotic prescribing practices in ICU settings.
OBJECTIVES: This study aims to determine the pattern of antibiotic prescribing and its alignment with the susceptibility test result among ICU patients in the Eastern Region of Saudi Arabia.
METHOD. This retrospective, cross sectional study included patients aged 18 years and older, admitted to the ICU in Dammam Medical Complex, Saudi Arabia and with a confirmed bacterial infection from 1st January to 31st December 2019. Descriptive statistics were used to describe the included patients, whereas for comparison, the student-T test for continuous variables and Chai-square test for binary regression was used. Statistical analyses were performed using Statistical Package for the Social Sciences (SPSS) software version 23.
RESULT: Among 277 patients (mean age: 49 (SD: 22) years, 56% male), Methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter accounted for 76% of included cases. Only 17.3% of patients received antibiotic prescriptions that corresponded accurately to sensitivity test results. Carbapenems and polymyxins were the most frequently prescribed antibiotics, raising concerns due to their use even in cases with evidence of resistance.
CCONCLUSION: The low rate of alignment between antibiotic prescription and the susceptibility test result raises concerns towards suboptimal prescribing practices which potentially exacerbates resistance issues and negatively impacts on patient outcomes. Implementing strategies that incorporate local antibiograms and integration with the susceptibility test findings are essential steps toward optimizing antibiotic prescriptions, reducing resistance, and improving clinical outcomes for ICU patients with bacterial infections.