Abstract
Introduction: Infections are the leading cause of morbidity and mortality in Intensive Care Units (ICUs), making antibiotics the most prevalent and costly pharmacological class in this sector, accounting for 20% to 50% of the institution’s pharmaceutical costs. The ICU environment, characterized by high patient complexity, multiple invasive procedures, and the use of immunosuppressive therapies, favors the occurrence of infections. Empirical, indiscriminate, and prolonged use of antimicrobials increases length of hospital stay, mortality rates, and healthcare costs. This scenario is often the result of the absence of robust clinical protocols and an active clinical pharmacy service, leading to irrational antimicrobial use. Objective: To analyze the antibiotic dispensing profile in the Intensive Care Unit (ICU) pharmacy of the General State Hospital (HGE) in Maceió, Alagoas. The analysis included prescriptions dispensed from January to June 2024, focusing on variables such as gender, antibiotic class, duration of therapy, and cost. Methods: A descriptive, retrospective, and quantitative study conducted in the ICU of HGE. Data collection was based on hospital pharmacy dispensing control spreadsheets, restricted to the ICU pharmacy (January to June 2024), with the methodological limitation of no access to patient medical records for clinical correlation. The analyzed variables included demographic data, dosage regimen, outcome, and prescribed drug, with prior authorization from the Hospital Infection Control Committee (CCIH). Results: The analysis of results, involving 258 patients, revealed a predominantly male patient profile (72.09%) and a mortality rate ranging from 21.31% to 28.33% throughout the semester. A high volume of antibiotic use was observed, with an average of 277 monthly prescriptions and an intensive polytherapy regimen, in which each patient received between 4.1 and 4.7 different antibiotics. The pharmacoeconomic impact was substantial, with an average monthly cost per patient ranging from R$ 1,008.05 to R$ 2,048.96, and a maximum individual cost for a single treatment reaching R$ 12,388.13. The most prevalent restricteduse antimicrobials, concentrating both frequency and costs, were Meropenem 1g, Vancomycin 500mg, Polymyxin B 500,000 IU, Teicoplanin 400mg, and Linezolid 600mg. Conclusions: Despite the limitations, the study successfully established the dispensing profile and the significant pharmacoeconomic impact of antibiotic therapy in the ICU of HGE. The high prescription rate of Meropenem, a broadspectrum carbapenem, indicates a treatment scenario focused on complex and potentially multidrugresistant infections. These data are essential for pharmaceutical care management, enabling the generation of quality indicators to guide service improvement and identify discrepancies in prescribing patterns. This situational diagnosis serves as the basis for the future implementation of an Antimicrobial Stewardship Program. The importance of strengthening the role of the clinical pharmacist in collaboration with the CCIH is evident, aiming to optimize control and dispensing processes, thereby promoting the rational use of antimicrobials and patient safety.
