Cost and Antibiotic Utilization of Pneumonia Patients in Intensive Care Unit

Objective of this study is to evaluate the cost and antibiotic utilization of pneumonia patients admitted in intensive care unit. It was a retrospective study. Details required for antibiotic utilization and cost analysis were acquired from hospital files. Out of 320 cases evaluated 110 cases were of pneumonia.28.2% of people had pneumonia as their primary diagnosis and 71.8% had hospital acquired/aspiration pneumonia. The mean length of ICU stay was 3.30± 1.91 days. 21.8% patients were put on ventilator. The mortality rate was 34.5%. Betalactum along with betalactamase inhibitor antibiotics were prescribed for 91% patients, Carbapenams for 20%, anti-staphylococcal antibiotic for 51% of patients and macrolides and miscellaneous antibiotics were prescribed in 25.5% and 36.4% patients respectively. Betalactum antibiotic along with betalactamase inhibitor and clindamycin combination was most commonly prescribed antibiotic. Average cost per patient who was not put on ventilator was Rs 27,123 where as ventilated patient per cost was Rs44, 812. This study showed that one third of ICU admissions was due to pneumonia. Highest numbers of pneumonia were hospital acquired/aspiration pneumonia. Cost of ventilator supported pneumonia was two times more than non-ventilated pneumonia. Ventilator support was the most expensive intervention adding to the cost of care followed by cost of antibiotics and investigations.