Indian Journal of Pharmacy Practice, Vol 9, Issue 2, Apr-Jun, 2016 123 Research Artcle www.ijopp.org Comparative Drug Utilization of Antimicrobial Agents in Medical and Respiratory Intensive Care Units of a Tertiary Care Teaching Hospital in South India Bincy Benjamin 1 , B Sajeev Kumar 1* , Padmaja Udaykumar 2 , V.B. Narayana Swamy 1 1 Department of Pharmacy Practice, Karavali College of Pharmacy, Mangalore-575 028, INDIA. 2 Department of Pharmacology, Father Muller Medical College Hospital, Mangalore-575 002,INDIA. ABSTRACT Introduction : Drug Utilization Evaluation play a key role in managing healthcare system to understand, interpret, evaluate and improve the prescribing, administration and use of medications. Objective: To evaluate and compare the drug utilization of antimicrobials in Medical and Respiratory Intensive Care Units so as to include restriction policies. Methods: A prospective, observational study was performed on 209 prescriptions. The total number of drugs, dose, route, sensitivity pattern and cost were collected from in-patient records. The Defined Daily Dose/100 bed days of the most frequently prescribed antimicrobials was also calculated. Results: Out of the 1046 drugs prescribed in the Medical Intensive Care Unit, 167 antimicrobials were prescribed with an average of 2 drugs per prescription. The average length of stay was 4 (±1.4) days. Frequently prescribed antimicrobials were ceftriaxone, amikacin and clindamycin. The DDD/100 bed days for those drugs was 22.2, 6.9 and 5.9 respectively. The widely prescribed combinations were piperacillin+tazobactam and cefoperazone+tazobactam. In only 23% of the cases sensitivity test was performed. The most prevailing organisms were E.Coli (53%) and Acinetobacter sps (23%). Colistin and meropenam were the most sensitive antimicrobials for most microorganisms. In Respiratory Intensive Care Unit, out of 1024 drugs, 163 antimicrobials were prescribed with an average of 2 drugs per prescription. The average length of stay was 4 (±1.4) days. Ceftriaxone (40%) was found to be most commonly prescribed drug followed by clindamycin (17%), levofloxacin (12%) and meropenam (11%). The generally prescribed combination was piperacillin+tazobactam (30%). The DDD/100 bed days was found to be high. In only 20% of the cases sensitivity test was performed. Acinetobacter sps was the most frequently isolated pathogen and all microorganisms were sensitive to colistin. Conclusion: There is a need of anti-microbial agents usage guidelines and restriction policies for the rational prescribing of antimicrobials in critically ill patients. Key words: Drug Use Evaluation, Antimicrobial Agents, MICU, RICU, Sensitivity pattern, Defined Daily Dose. DOI: 10.5530/ijopp.9.2.11 Address for correspondence: Dr. B. Sajeev Kumar, Professor and Head-Pharm D Programme, Department of Pharmacy Practice, Karavali College of Pharmacy, NH.13, Vamanjoor, Mangalore -575028, D.K. Dist., Karnataka State, INDIA. Phone no: +919495817507, Fax: +91 0824226365 E-mail: drsajeev2016@gmail.com, bsajeev2001@yahoo.com INTRODUCTION Drug therapy plays a crucial role in improving human health by enhancing the quality of life and extending the life expectancy. A method to evaluate and improve drug use is by conducting Drug Utilization Studies (DUS). Drug Utilization is defned by the WHO as the marketing, distri- bution, prescription, and use of drugs in society with special emphasis on the resulting medical, social, and economic consequences. 1 The World Medicines Situation Report of 2011 concludes that inappropriate antibiotic use, including overuse and misuse, is a serious global problem. Also, estab- lished and newly emerging infectious diseases are increasingly threatening the health of population. 2 Intensive Care Unit (ICU) patients are a diverse group, who often suffer from severe illness, multiple organ dysfunction