First Indian Guidelines For Antibiotic Use In ICU

Mumbai, 9 March 2019: Experts from across the country, in a first-of-its-kind initiative, have developed national guidelines for antibiotic use in intensive care units (ICUs). The 40-doctor committee, comprising members of the Indian Society of Critical Care Medicine (ISCCM), has prepared the country’s first India-centric guidelines for antibiotic prescription in the ICU. The ISCCM has recently discussed the guidelines with the Indian Council of Medical Research (ICMR) and who will be submitting it to the Union health ministry.
 
It took two years for the experts to come up with the guidelines and in this members of the ICCMS were aided by experts from the All India Institute of Medical Sciences (AIIMS) Delhi. The comprehensive team included Dr Randeep Guleria, director of AIIMS and Dr GC Khilnani, former head of department of pulmonary and critical care medicine, AIIMS.
 
The guidelines have been made after witnessing the mortality rate which remains consistently high due to severe sepsis, septic shock, acute infective diarrhoea, ventilator associated pneumonia, abdominal infection, skin, soft tissue infection, bacterial meningitis and multi-drug resistance pathogens in ICUs. The guidelines have been discussed with the ICMR director Balram Bhargava and ISCCM is in process of sending the guidelines to ICMR and the ministry of health for approval.
 
Former president of ISCCM, Dr Kapil Zirpe, who heads the neuro-trauma unit at Ruby Hall Clinic, Pune, said, “This are the first time such detailed guidelines has been drafted that are India centric. The guidelines are for Indian doctors and have been prepared after considering the Indian perspective on dosage, combination of drugs and expenses.”
 
He added, “The guidelines will help medical institutions set up proper structure for using antibiotics and help understand the kind of infection and analyse what kind of antibiotic will work for the patient.”
 
Dr Subhash Dixit, president of ISCCM, said, “This will help in planning the antibiotic policy and strategies of using the antibiotics in ICU. It will avoid the misuse and over use of antibiotics.” It will help to precisely pinpoint what antibiotics to start a specific drug with. It would streamline the use of antibiotics in a judicious way.”
 
The guidelines have been put together after extensive meetings and perusal of accumulated literature. The 160-page document there is evidence based recommendation for each and every antibiotic that has been given. The evidence relates to where, when and which antibiotic has to be used taking the Indian perspective into consideration. The recommendation is on basis of the Indian microbial flora not relying on western scenarios. The Indian literature has also been compared with the western guidelines.ET Healthworld