Drug Use Evaluation Antimicrobial in Inpatient Department Phukhieochalermprakiat Hospital Chaiyaphum Province

Abstract

Background : Antimicrobial use is an important factor contributing to resistance of pathogens. Improper drug use causes higher mortality in infectious disease patients. At the same time, excessive use of antimicrobial agents will contribute to the problem of drug-resistant infection and rising drug costs as well.

            Objective : To study antimicrobial prescribing characteristics requiring a drug use evaluation form and evaluate the appropriateness of indications, duration, treatment outcome, cost and drug related problem of inpatients.

            Method and material : This study was a descriptive study of prospective drug utilization review. The data were collected from medical record of patients receiving piperacillin/tazobactam (tazocin^®), meropenem, cefoperazone/sulbactam (sulperazone^®), colistin, vancomycin or levofloxacin during October 2018 to September 2019 in Phukhiao Chalermprakiat Hospital. To determine the nature of drug used, assess the appropriate used, clinical outcome after end of treatment, cost of the drug, drug related problem, pharmacist’s reccomentation and doctor’s responseness. The data were presented in frequency and percentage.

              Result : The most commonly of drug were tazocin^® (734,409 bath, DDD = 3.18). Patients were clinically cured from the infection 70.50%. The use of antimicrobials was an empirical therapy (61.93%) and 38.07% had specific therapy, which was used for Acinetobacter baumannii, K.pneumoniae, E.coli and P.aeruginosa, respectively. Inappropriate use of antimicrobial was identified in 36.93% of DUE froms particularly relates to tazocin^®,  meropenem and sulperazone^®. Doctors accepted to pharmacist’s reccomentation 85.63%, de-escalation therapy 22.28% and switching from IV to oral therapy 24.16%

Conclusion : The appropriateness of drug use was acceptable. However, almost 40% of courses still concerned irrational use. Educational interventions, intensive PTC regulation, infection control management and empowerment of adherence to a strict antibiotic prescribing policy can help significantly to overcome this problem.