Analysis of the use of carbapenems and piperacillin-tazobactam in non-critical patients

Objective: To evaluate the use of piperacillin-tazobactam, imipenem and meropenem by determining if the indication, the dosage and the administration times were adequate according to the current guidelines and to review if the prescription was made accordingly to the criteria established in the hospital. Method: Six month retrospective observational study has been done in a secondlevel university hospital. Daily, treatment and clinical data were recorded. At hospital discharge the appropriateness of prescriptions was assessed by members of the Committee of Infectious diseases. Results: 214 prescriptions were studied and the 57.5% of them were appropriate: 57.8% of piperacillin-tazobactam (No. = 118), 59.3% of imipenem (No. = 81) and 47.4% of meropenem (No. = 19). The reasons of inadequacy were: 57.1% availability of another drug of choice, 22% for incorrect dose, 16.5% for wrong treatment duration and 4.4% for inappropriate frequency. Pneumology was the department with highest percentage of appropriateness. As indication, was febrile neutropenia. Conclusion: Outcomes show that approximately 60% of the prescriptions were appropriate. The most common reason for inappropriateness was the availability of another alternative of choice. Measures to increase the quality of prescriptions are: to review prescription protocols, to spread the outcomes to health professionals and to promote rational use of antimicrobials in empiric treatment. After implantation it will be assessed anew to evaluate impact of measures