Cross-sectional study to track antibiotic consumption and its appropriateness in an intensive care setting of a tertiary care hospital using AWaRe tool of World Health Organization (WHO).

Background: Incorporating AWaRe classification metrics provide a structured approach to evaluating antibiotic consumption and guiding future interventions for better antibiotic stewardship in healthcare facilities. The study aimed to quantify antibiotic consumption and assess its appropriateness in an intensive care unit of a tertiary care hospital in South India using the WHO's AWaRe tool. Methods: This study was conducted in a South Indian ICU over 2 months, including prescriptions with at least one antibiotic for patients admitted within 2 weeks. Around 100 prescriptions were included based on ICU admission statistics. An AWaRe tool by WHO was used to analyze antibiotic consumption and appropriateness. Results: 201 antibiotics were prescribed, with an average of 2 antimicrobials per patient. 78.6% administered parenterally, 21.4% orally. 29% cases had clinical samples sent for Culture & Sensitivity testing. Only 29% cases showed escalation or de-escalation of antimicrobials based on clinical response. Conclusions: The study highlighted the empirical nature of antibiotic prescriptions, limited microbiological guidance, and inadequate adjustments based on clinical responses. These findings emphasize the need for improved guidelines and practices to optimize antibiotic use in intensive care settings, ensuring appropriateness and effectiveness in patient care.