How antibiotics are being used in ICU patients in a hospital in Northeast India

What is it about?

This study looked at how antibiotics are used in the Medicine, Surgery, and Neurosurgery Intensive Care Units (ICUs) of a teaching hospital in Northeast India. By reviewing 359 ICU patients over one year, we measured how much of each antibiotic was used and categorized them using the World Health Organization’s AWaRe classification—Access, Watch, and Reserve groups. We used internationally accepted metrics such as Defined Daily Dose (DDD) and Days of Therapy (DOT) to quantify antibiotic consumption. The study found that broad-spectrum ‘Watch’ antibiotics were used much more often than the safer, narrow-spectrum ‘Access’ antibiotics. Prophylactic antibiotic use—often not aligned with recommended guidelines—was also very common, especially in the neurosurgery ICU. Overall, the results show clear patterns of overuse of broad-spectrum antibiotics and limited use of culture-guided, targeted therapy.

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Photo by Polina Lavor on Unsplash

Photo by Polina Lavor on Unsplash

Why is it important?

Antimicrobial resistance (AMR) is a major global health threat, and India is among the world’s highest consumers of antibiotics. ICUs are particularly vulnerable places where resistant infections spread rapidly. Understanding how antibiotics are used is the first step toward improving prescribing practices. This study provides real-world data from a resource-limited setting—an area where such evidence is scarce. By showing which antibiotics are overused, where inappropriate prophylaxis occurs, and where stewardship gaps exist, the findings can directly help hospitals: 1. Strengthen antimicrobial stewardship programs 2. Reduce unnecessary broad-spectrum antibiotic use 3. Improve culture-guided treatment 4. Align practice with WHO and national AMR guidelines This evidence is critical for preventing the rise of drug-resistant infections and improving patient outcomes.

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