Drug Utilization Evaluation of Two Broad-Spectrum Antimicrobials: Cefepime and Piperacillin/Tazobactam in a Teaching Hospital in Tabriz, Iran

Abstract

Background: The inappropriate use of antibiotic leads to microbial resistance, nosocomial infections and increased hospital costs. The present study was designed to evaluate DUE (Drug utilization evaluation) of cefepime and piperacillin-tazobactam drugs consumption patterns. Methods: This study was a descriptive and cross–sectional which performed 2014 on 140 hospitalized patients in Sina hospital Tabriz, Iran. Demographic data, duration of prescription, dose, dosage adjustment in renal impairment and accompanied prescribed antibiotics were extracted from medical files. UpToDate and American Hospital Formulary Service (AHFS) drug information 2012 were considered as standards of rational prescribing. Data analysis was performed by SPSS 18 software. Results: In 77.4% and 90% of the prescribed doses of cefepime and piperacillin-tazobactam for patients with guideline. The most common antibiotic administered with cefepime was ciprofloxacin (37 cases). In 21 patients, cefepime dosage should have been adjusted according to renal impairment, whereas it has done only in 16 (22.9%) patients. Culture was done in 60 (85.8%) cases. In 22(31.4%) patients, the result of culture was negative. Drug dosage and indication were appropriate in 34 (48%). The most common antibiotic administered with Piperacillin/tazobactam was vancomycin (45 cases). In 9 patients, Piperacillin/tazobactam dosage should have been adjusted according to renal impairment and it has done. Culture was done in 53 (75.8%) cases. In 9(12.8%) patients, the result of culture was negative. Conclusion: The results showed that there was an injudicious use of cefepime and piperacillin/ tazobactam at our hospital, evidenced by the significant number of inappropriate empiric prescriptions and drug modifications