Title : Patterns of antibiotic prescription and duration in intensive care: Insights from a five year retrospective study
Abstract:
Background: Antibiotics are among the most prescribed medications worldwide. However, inappropriate use is associated with antimicrobial resistance, adverse effects, and increased healthcare costs. Optimizing treatment duration is a central component of antibiotic stewardship.
Objective: To describe antibiotic treatment durations in critically ill patients and evaluate adherence to evidence-based recommendations.
Methods: A descriptive retrospective study was conducted over five years (January 2020–November 2024) in the surgical emergency intensive care unit “P33.” A total of 503 patients receiving antibiotic therapy for ≥48 hours were included. Data on infection type, treatment duration, antibiotics used, and ICU length of stay were analyzed.
Results: The median duration of antibiotic therapy was 8 days for respiratory infections, 7 days for bloodstream infections, 4 days for intra-abdominal infections, 6 days for catheter-related infections, 7 days for urinary tract infections, and 5 days for neuro-meningeal infections. The median ICU length of stay was 9 days. The most frequently prescribed antibiotics were β-lactams (40%)—notably ceftriaxone (13%) and imipenem (12%)—aminoglycosides (22%), fluoroquinolones (11%), and metronidazole (9%), often used in combination therapy.
Conclusion: Our findings highlight considerable variability in antibiotic duration across infection types and confirm a predominant reliance on broad-spectrum β-lactams and aminoglycosides. While increasing evidence supports shorter treatment courses with outcomes comparable to longer regimens, practice remains heterogeneous. Individualizing antibiotic duration and choice according to patient condition, infection site, and local microbiological ecology is essential to balance efficacy, resistance prevention, and safety.
