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Knowledge, Perception, and Antibiotic Prescribing Practice in the Intensive Care Unit: Findings from the Malaysian Public Setting.


ABSTRACT:

Introduction

Approach to managing infection in the intensive care unit (ICU) often varies between institutions and not many readily adapt to available local guidelines despite it was constructed to suite local clinical scenario. Malaysia already has two published guidelines on managing infection in the ICU but data on its compliance are largely unknown.

Objectives

A cross-sectional survey was carried out and sent to a total of 868 specialists working primarily in the ICU. The aim of this study was to explore knowledge, perception, and the antibiotic prescribing practice among specialists and advanced trainees in Malaysian ICU.

Materials and methods

A cross-sectional survey was used, consisted of three sections: knowledge, perception, and antibiotic prescribing practice in ICU. Three case vignettes on hospital-acquired pneumonia (HAP), infected necrotizing pancreatitis (INP), and catheter-related bloodstream infection (CRBSI) were used to explore antibiotic prescribing practice.

Results

A total of 868 eligible subjects were approached with 104 responded to the survey. Three hundred eighty-nine antibiotics were chosen from seven different classes in the case vignettes. All respondents acknowledged the importance of pharmacokinetic/pharmacodynamic (PK/PD) in antibiotic optimization and majority (97.2%) perceived that current dosing is inadequate to achieve optimal PK/PD target in ICU patients. Majority (85.6%) believed that antibiotic dose should be streamlined to the organisms' minimum inhibitory concentration (MIC). In terms of knowledge, only 64.4% provided the correct correlations between antibiotics and their respective PK/PD targets. Compliance rates in terms of antibiotic choices were at 79.8%, 77.8%, and 27.9% for HAI, INP, and CRBSI, respectively.

Conclusion

Malaysian physicians are receptive to use PK/PD approach to optimize antibiotic dosing in ICU patients. Nonetheless, there are still gaps in the knowledge of antibiotic PK/PD as well as its application in the critically ill, especially for β-lactams.

SUBMITTER: Rozali MA 

PROVIDER: S-EPMC8021041 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Knowledge, Perception, and Antibiotic Prescribing Practice in the Intensive Care Unit: Findings from the Malaysian Public Setting.

Rozali Muhammad Azrai MA   Abd Rahman Norny Syafinaz NS   Sulaiman Helmi H   Abd Rahman Azrin Nurul AN   Atiya Nadia N   Wan Mat Wan Rahiza WR   Jamaluddin Mohd Fadhil MF   Mazlan Muhd Zulfakar MZ   Mat Nor Mohd Basri MB   Hasan Mohd Shahnaz MS   Abdul-Aziz Mohd Hafiz MH  

Journal of pharmacy & bioallied sciences 20201105 Suppl 2


<h4>Introduction</h4>Approach to managing infection in the intensive care unit (ICU) often varies between institutions and not many readily adapt to available local guidelines despite it was constructed to suite local clinical scenario. Malaysia already has two published guidelines on managing infection in the ICU but data on its compliance are largely unknown.<h4>Objectives</h4>A cross-sectional survey was carried out and sent to a total of 868 specialists working primarily in the ICU. The aim  ...[more]

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