Analysis of the Utilization of Carbapenem Antibiotics in the Wards of Our Hospital from 2008 to 2010
0
Citation
0
Reference
20
Related Paper
Abstract:
OBJECTIVE: To analyze the utilization of carbapenems antibiotics in the wards of our hospital from 2008 to 2010. METHODS: The information of medical orders of carbapenem use in 38 departments of our hospital was collected from hospital information system (HIS) of our hospital from 2008 to 2010. Bacteria isolation and drug resistant rate of imipenem/cilastatin were abstracted from Hospital Infection Control Information pressed by our hospital to analyze the rational use of imipenem antibiotics. RESULTS: The utilization of carbapenem antibiotics is stable during the past three years, mainly in ICU and cadre department in which old patients concentrate. More clinicians are preferred to using meropenem rather than imipenem or cilastatin by 2010. CONCLUSION: The utilization of carbapenems antibiotics in our hospital is reasonable basically.Keywords:
Carbapenem
Cilastatin
Isolation
Cite
Background: ＂Acinetobacter baumannii＂ complex infections are associated with high morbidity, mortality and cost. Increased use of anti-pseudomonal carbapenems (imipenem, meropenem) was associated with increased rates of carbapenem-resistant acinetobacter baumanni (CRAB) isolates. Pharmacist intervention can play a major role in the appropriate use of antibiotics. Objectives: To evaluate the impact of an infectious disease pharmaceutical care model (IDPCM) in an antibiotic stewardship program on anti-pseudomonal carbapenem consumption and expenditure. Methods: Training of pharmacists began in August 2013. The IDPCM was implemented in January 2014 which included intensive care unit (ICU) pharmaceutical care, infectious disease pharmaceutical care and evaluation of antibiotic prescriptions including carbapenems. In ward rounds, clinical pharmacists presented cases with the need for antimicrobial changes and complicated patients on broad-spectrum antimicrobials. Pharmacists provided suggestions for changes to antibiotic use to doctors. Comparison of carbapenem consumption and cost pre- and post-implementation of the IDPCM were conducted between the periods January to August 2013 and 2014. Results: Four pharmacists completed training and participated in an antibiotic stewardship program. Imipenem, meropenem and total carbapenems consumption decreased 17%, 18% and 5% respectively. Total carbapenem expenditure declined by 12%. 248 interventions were made by clinical pharmacists (including 59 carbapenem interventions) during the 8-month study period. The doctors' acceptance rate was 88%. The most common interventions were inappropriate antibiotic selection 44%, dose adjustment 29%, and IV incompatibility 19%. Conclusion: Implementation of IDPCM in an antibiotic stewardship program can decrease the carbapenem consumption and decrease total carbapenem expenditure. This pharmaceutical care model could be implemented into daily practice.
Carbapenem
Antimicrobial Stewardship
Acinetobacter baumannii
Defined daily dose
Cite
Citations (0)
: Background: Antibiotics are among the most frequently used drugs worldwide. An average 35% of the total health budget is spent on antibiotics. Overuse and/or misuse of antibiotics has significant consequences, such as increased cost, bacterial resistance, therapeutic failure, drug toxicity and drug interactions. The objective of this study was to evaluate the prescribing pattern of antibiotics in Medicine ward of a tertiary care hospital in Bangalore. Methods: Hospital based retrospective study carried out in medicine ward of a tertiary care hospital in Bangalore. A retrospective study was carried out by collecting the data of the medication orders given for a period of 12 months. A total of 741 medication order was studied of which 470 were for males and 271 for females, between the age group of 15-92 years. Results: The results showed that the most commonly prescribed class of antibiotics were: Cephalosporins 571 (47.22%), Quinolone 237 (19.6%), Cephalosporins + Penicillinase inhibitors 159 (13.15%), Penicillin + Penicillinase inhibitor 73 (6.03), Aminoglycoside 27 (2.23%), Macrolides 13 (1.07%), Sulphonamides 1 (0.08%), Tetracyclines 2 (0.16%) and others 126 (10.4%). Conclusion: The most commonly prescribed class of antibiotics was Cephalosporins. Detailed knowledge of antibiotic prescription pattern is important to monitor the rational use of antibiotics and is important before the therapeutic policies and measures can be implemented. It’s recommended to involve an active clinical pharmacist in the hospital to study the drug use pattern and intervention as and when necessary.Key words: Prescribing, Antibiotics, Rational Use, Tertiary Care Hospital, Therapeutic Policies.
Defined daily dose
Cite
Citations (1)
OBJECTIVE:To investigate the application status of meropenem(antibacterial agent) in our hospital and to promote its use in clinic,relieve patients' economic burden and lower the antibiotic resistance rate.METHODS:A total of 300 medical records of the inpatients treated with meropenem sampled in our hospital during Jan.-Jun.period of 2012(50 cases monthly) were reviewed and given special comments in accordance with the related criteria.RESULTS:The reviewing of the cases showed that the top 3 departments ranked by the number of patients using meropenem included cancer center,neurosurgery department and department of infectious diseases.Of the 300 inpatient cases reviewed,bacterial culture was performed in 234(78%).The effective rate for the meropenem-treated patients was as high as 82.7%(248/300).The rate of rational administration of meropenem was 77%(231/300).CONCLUSION:From the findings we can see that the drug use in most of the patients was rational,yet there were still many irrational phenomena that manifested as non-indication drug use,improper dosage and administration or irrational drug combination etc.The level of rational use of drugs remains to be improved further.
Medical record
Cite
Citations (0)
Objective : To evaluate utilization of imipenem and meropenem at the Colombo South Teaching Hospital (CSTH) Methods : The study was performed at CSTH in two parts ; a retrospective descriptive study (Part I) and a prospective descriptive study (Part II). In Part I, utilization data on carbapenems in 2009 and 2010 were obtained by reviewing records at the in-door pharmacy. In Part II, bed head tickets (BHTs) of the patients treated with carbapenems were assessed from 01/01/2011 to 15/06/2011. Appropriateness of initiating carbapenem treatment was evaluated according to the Sri Lanka Medical Association (SLMA) antibiotic guidelines. Results : Use of meropenem and imipenem during 2009 and 2010 in CSTH is summarized in Table1. Item(No. of vials) Year Variance (%) 2009 2010 Meropenem 1g 2264 3010 +32.95% Meropenem 500mg 2258 4418 +95.66% Imipenem 500mg 1056 648 -38.64% Table1: Use of meropenem and imipenem during 2009 and 2010 in CSTH 179BHTs were reviewed to evaluate whether carbapenems have been prescribed according to SLMA guidelines. According to the evidence recorded in BHTs in 55.31% of the patients carbapenems have not been prescribed according the guidelines. The most common indications for inappropriate use were urinary tract infections(12.29%), post-surgery 10.61%) and community acquired pneumonia(14.52%). Conclusions : Carbapenems should be used for serious and life threatening infections suspected or proven to be caused by bacteria resistant to other commonly used antimicrobials but susceptible to carbapenems. Inappropriate use of carbapenems increases the development of bacterial resistance and use may not be cost effective. Therefore we suggest that guidelines on usage of antibiotics need to be established and clinicians should adhere to such guidelines.
Carbapenem
Cite
Citations (0)
Antibiotic resistance, a major negative consequence of antibiotic overuse, is one of the mainstay problems worldwide. Various means have been used to control antibiotic usage including the use of an antibiotic order form (AOF), restricted antibiotic formularies and provision of educational information. The present study was designed to evaluate the use of antimicrobial in a 1,000-bed university hospital. Antimicrobial agents which are likely to be abused namely ceftazidime, cefepime, cefoperazone/sulbactam, imipenem/cilastatin, meropenem, ciprofloxacin, netilmicin, vancomycin, azithromycin and clarithromycin were selected for evaluation. A simple AOF with educational information was used as a mean to follow-up the treatment. The investigator collected data from the filled AOF and the patient's charts, Department of Internal Medicine from June - November 2000, and all relevant data were assessed. The appropriateness of antibiotic use was assessed according to the criteria specified in the AOF showed that 74% of these antibiotics were prescribed appropriately. This may prove the effectiveness of the system used in the present study. However, 348 of the 430 prescriptions (80.9%) were prescribed empirically at the initial stage for treatment of nosocomial infections in patients with serious conditions like pneumonia, sepsis and febrile neutropenia. Drugs that were frequently used empirically were ceftazidime (37.9%), imipenem/cilastatin or meropenem (19 .3% ), and cefoperazone/sulbactam ( 12.1 % ) respectively. Ceftazidime and imipenem/cilastatin or meropenem were also frequently used inappropriately among 111 prescriptions that were classified as an inappropriate prescribing. The most common misuses were prescriptions of the drug that did not follow the specified indications (70 prescriptions), no dosage adjustment in patients with renal impairment (39 prescriptions), improper dose (12 prescriptions) and improper dosing interval (9 prescriptions). The results suggested overuse of certain antibiotics remain to be an unsolved problem. A better monitoring and strictly control the use of the problematic antibiotics, i.e. ceftazidime, imipenem/cilastatin or meropenem and vancomycin are essential to promote the rational drug use as well as to reduce drug resistance.
Cefepime
Formulary
Cilastatin
Cefoperazone
Sulbactam
Cite
Citations (12)
Pharmacoeconomics
Cilastatin
Carbapenem
Formulary
Cite
Citations (3)
Carbapenem
Carriage
Antimicrobial Stewardship
Carbapenem-resistant enterobacteriaceae
Cite
Citations (2)
OBJECTIVE: To investigate the pediatric utilization of antibiotics in our hospital to provide references for rational use and management of antibiotics.METHODS: During Oct.-Dec.period of 2010,a total of 560 case files of the pediatric patients of our hospital who were treated with antibiotics were collected and analyzed statistically.RESULTS: The ratio of antibiotics was high in department of pediatrics.Among the antibiotics,cephalosporin was used most frequently,followed by cephamycins and macrolides.In terms of DDDs ranking,the top 5 antibiotics were ceftizoxime,cefmenoxime,azithromycin,cefmetazole and ceftazidime.The antibiotic use was somewhat irrational.CONCLUSION: The management of antibiotics in department of pediatrics should be enhanced and it is necessary to tighten clinicians' learning on the knowledge regarding the use of antibiotics.
Cefmetazole
Ceftizoxime
Cite
Citations (0)
OBJECTIVE:To analyze the utilization of antibiotics in the inpatients of our hospital for clinical references of rational use of antibiotics.METHODS:In this retrospective survey,the medical records of 360 patients who had been treated with antibiotics during hospitalization but discharged from our hospital sampled by clinical pharmacy group in 2008 were analyzed in respect of the utilization of antibiotics.RESULTS:A total of 36 kinds of antibiotics were used in these patients,leading the first 3 places were cefuroxime sodium,cefotaxime sodium and levofloxacin.CONCLUSION:The use of antibiotics is somewhat irrational;therefore,the rational use level of antibiotics remains to be improved further.
Cefuroxime
Medical record
Hospital pharmacy
Cite
Citations (0)
Carbapenem
Medical record
Antimicrobial Stewardship
Cite
Citations (6)