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Objective To establish the drug use evaluation ( DUE) of Dolasetron, evaluate the rationality of the clinical use of Dolasetron and provide a reference for the rationally clinical use of Dolasetron．Methods On the basis of Dolasetron DUE criteria, a retrospective analysis was made in 794 hospitalized patients from January 2021 to June 2021. Results The drug use evaluation criterion on Dolasetron consisted of drug indications, drug use process, the result of drug use and indication management. Conclusion There are some inappropriate medication problems in Dolasetron utilization in the hospital. The DUE criterion is very practical which could be used to standardize the clinical utilization of Dolasetron.
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AIM: To provide reference for rational application of human albumin in pediatrics. METHODS: On the basis of the human albumin instructions, refer to the relevant guidelines and literature on the use of human albumin in pediatrics, draft the first draft of the Drug Use Evaluation standard and list it into an expert consultation questionnaire, which is finalized through two rounds of expert discussions. This standard was used to retrospectively evaluate the medical records of hospitalized children who used human albumin in the Pediatric Department of our hospital from June 2019 to January 2020. RESULTS: The standards established in this study included three primary indicators of medication indications, medication process, medication results and 6 secondary indicators of indications, contraindications, treatment process monitoring, drug application, efficacy, and adverse reactions. A total of 269 medical records of hospitalized children were included in this evaluation, of which newborns accounted for the highest proportion (56.88%). 229 cases met the indications, accounting for 85.13%; 251 cases were tested for serum albumin concentration before medication, accounting for 93.31%; after medication, the relevant indicators reached the standard, and the symptoms improved significantly in 226 cases, accounting for 84.01%. CONCLUSION: The Drug Use Evaluation criteria for pediatric human albumin established by our hospital has strong practicability, which is conducive to discovering problems or deficiencies in clinical medication and promoting rational clinical use of medication.
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Background:Drug use evaluation is an ongoing systematic process designed to maintain the appropriate medication during & after dispensing in order to assure appropriate therapeutic decision making andpositive patient outcome. Methods:An institutional based cross-sectional study design was conducted to analyze drug use of vancomycin by using medication charts and medical note of patients that were admitted in the medical ward of Yekatit 12 Hospital Medical College. Data was analyzed using SPSS version 20. Patients who were admitted from medical ward and whose age were≥18years were eligible provided that they take Vancomycin during the study period were included and Patients with medical records of insufficient or illegible information’s were excluded. Structured check list was used for data collection, and the samplesize was 169. Convenience sampling technique was used.Results:Among 169 patients 136(80.5%) had empiric treatments, the remaining 33(19.5%) had specific treatments. Among 169 patients 61(36.1%) hadInfection during his/her stay in hospital of which 47(77%) were hospital acquired pneumonia, 169 patients 39(23.08%) had Vancomycin indication for hospital acquired pneumoniafollowed by 21 (12.4%), 21(12.4%), meningitis and PCP respectively. The finding indicated that only 135(79.9%) were appropriate regarding frequency, 124(73.4%) were appropriate regarding dose, 104(61.6%)were appropriate regarding duration, and the appropriate indication were only 128(75.7%).Conclusions:Vancomycinewas mostly indicated as empiric therapy and only 135(79.9%) were appropriately prescribed with respect to frequency, 128(75.7%) were appropriate regarding indication and 124(73.4%) were appropriate regarding to dose, 104(61.6%) were appropriate regarding to duration. All physicians should prescribe drugs according to the guidelines.
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OBJECTIVE:To evaluate the rationality of cefoxitin use in our hospital. METHODS:Evaluation index and evalua-tion criteria were established on the basis of DUE. The relative weight of evaluation index were calculated by using attribute-based AHM weight method,and the gas between medical orders and complete rational ones were evaluated by using TOPSIS processing method. The proportion of rational medical orders were calculated to evaluate the rationality of drug use. RESULTS:Among 116 medical records,there were 19%reasonable medical orders(including 4.3%complete reasonable medical orders,5 cases),50%ba-sically reasonable medical orders(58 cases)and 31% unreasonable medical orders(36 cases). CONCLUSIONS:It is reasonable and feasible to use AHM weighted TOPSIS method to evaluate the rationality of cefoxitin. The utilization of cefoxitin in our hospital is basically reasonable,but there are still many problems.
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OBJECTIVE:To establish drug use evaluation(DUE)criteria for tigecycline,and to provide reference for rational use of tigecycline. METHODS:Based on tigecycline instructions,referring to related specifications and literatures,DUE criteria for tigecycline was established. And on a basis of it,referring to DUE criteria,in retrospective study,the utilization of tigecycline in 179 inpatients of some one hospital during Nov. 2012-Oct. 2016 was evaluated and analyzed in respects of management indexes, medication indication,medication duration,medication results,etc. RESULTS:The results for DUE of tigecycline in this hospital was that the proportion of patients with consultation records was 83.2%(aiming at 100%);microbial inspection rate was 90.5%(aiming at 80%);the coincidence rate of medication indication was 98.9%(aiming at 90%);the rates of solvent selection,ad-ministration route,drug interaction,incompatibility,drug use in special populations meeting the criteria were all 100%(aiming at 100%);the rate of prescribing authority was 20.1%(aiming at 100%);the rate of drug dosage and medication interval meeting the criteria were 7.3%(aiming at 100%);response rate was 54.7%(aiming at 80%). CONCLUSIONS:Established DUE criteria of tigecycline can standardize the clinical utilization of tigecycline.
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OBJECTIVE:To evaluate the effectiveness,safety and economics of antibiotics for inpatients with acute exacerba-tion of chronic obstructive pulmonary diseases (AECOPD),in order to promote rational use of antibiotics. METHODS:In retro-spective study,AECOPD inpatients were selected as research objects during 2013-2015 to evaluate the use of antibiotics. RE-SULTS:Three thousand one hundred and eighty-six AECOPD patients were enrolled in the study,and utilization ratio of antibiot-ics was above 90%. DDDs of Cefordizime sodium for injection ranked the first place in 3 years and was decreased in 2015,while those of β-lactam and carbapenems were increased. DDC of Meropenem for injection and Imipenem/cilastatin sodium for injection were the highest. Drug utilization index(DUI)of Cefodizime for injection was far more than 1.0,while DUI of Piperacillin sodi-um and sulbactam sodium for injection was much less than 1.0. Sort ratio(B/A)of Cefodizime sodium for injection ranged 1-2 in 3 years. B/A of Piperacillin sodium and sulbactam sodium for injection,Imipenem and cilastatin sodium for injection,Meropenem for injection were lower than 1.0. CONCLUSIONS:The indication of anti-infective treatment in AECOPD patients have been mas-tered strictly in our hospital;the utilization ratio of antibiotics is decreased year by year;the types of antibiotics are rational rela-tively,and the number of antibiotics which is rationally used is increased year by year. But the rationality of Cefodizime sodium for injection and Piperacillin sodium/sulbactam sodium for injection need to be improved.
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OBJECTIVE:To establish the Evaluation Criteria on Rational Use of Human Serum Albumin(HSA)in our hospi-tal,and to provide refereuce for rational use of HSA. METHODS:Referring to drug utilization evaluation(DUE)criteria of WHO and developed countries,based on the guideline of HSA use,Human Serum Albumin,Non-protein Colloid and Crystalloid Solu-tion Guidelines of USA University Hospital Consortium,Blood Products Prescription Evaluation Guideline of Beijing area,etc., Evaluation Criteria on Rational Use of HAS was established through experts discussion,and the use of HAS in 420 patients of our hospital were evaluated. RESULTS:The Evaluation Criteria on Rational Use of HSA mainly included indication,contraindication, usage and dosage,drug combination,incompatibility,etc. 414 patients (98.57%) detected serum albumin concentration before treatment;167 patients(39.76%)were in line with the indication;56 patients(13.33%)had contraindication in using HSA;352 patients(83.81%)met the criteria in usage and dosage,duration of treatment;there were 17 cases(4.05%)of unreasonable drug combination and 3 cases(0.71%)of incompatibility. CONCLUSIONS:The established criteria has strong practicability,and some problems and insufficiencies can be found in the clinical practice,is conducive to promote rational drug use in the clinic.
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OBJECTIVE:To provide reference for rational use of recombinant human granulocyte-colony stimulating factor (rhG-CSF) in cancer patients. METHODS:Referring to the expert advice and guideline of clinical application of rhG-CSF at home and abroad,DUE criteria on rhG-CSF for cancer patients was established;questionnaire was designed,and the medical re-cords of rhG-CSF in a third grade class A hospital was evaluated. RESULTS:The DUE criterion on rhG-CSF for cancer patients included 3 parts,such as drug indications,the course of medication and medication results,14 items in total. Through the imple-mentation of DUE,retrospective evaluation of 220 medical records showed that the application of rhG-CSF was up to the stan-dard in respects of drug indications,no contraindication,routine blood test and drug interaction monitoring at least twice every week,there still was irrational phenomenon. CONCLUSIONS:The established DUE criterion on rhG-CSF for cancer patients is with the characteristics of definite content,target and paracticabilitg,which can provide reference for the work development of clinical pharmacists.
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Background: The antimicrobial agents developed during the last 60 years are among the most dramatic examples of the advances of modern medicine. Many infectious diseases once considered incurable and lethal are now amenable to treatment with a few pills. They are among the most frequently prescribed medications to day although microbial resistance due to evolutionary and misuse threatens their continued efficacy. One mechanism to ensure correct prescribing and use is drug use evaluations studies. Objective of current study is to evaluate retrospectively of ciprofloxacin use from outpatient medical records by using pre- set criteria in Boru Meda hospital. Methods: A cross-sectional study on retrospectively collected data was used to evaluate ciprofloxacin use from outpatient medical history records existing from January 18, 2009 to January 17, 2010. Criteria along with thresholds set by experts for undertaking drug use evaluation for ciprofloxacin was used which is modified based on Ethiopian National Drug Formulary and Ethiopian National Standard Treatment Guideline, which are used in the hospital. Data was collected from January 18 to January 25, 2010 using appropriate data collection format. Results: Twenty six (65%) patients were in the age group of 15 to 49 years and twenty (50%) were females. Thirty eight (95%) and each of thirty seven (92.5%) cases were consistent with the Ethiopian National Standard Treatment Guideline & drug formulary regarding indication, dose & frequency of ciprofloxacin use in the outpatient department of Boru Meda hospital. 47.5% ciprofloxacin use has problem in duration of treatment . There were potential drug interactions with the drug in 40% of the cases. 10% of ciprofloxacin use was against contraindication. Conclusions: Due From the retrospective Drug Use Evaluation (DUE) study, it was identified that there was inappropriate ciprofloxacin use in the outpatient department of Boru Meda hospital even though the drug’s use regarding indications was a better performance and dosing practices were almost appropriate as per the criteria used for the study (assuming that there were no dose adjustments). There was a great problem concerning the duration of ciprofloxacin drug therapy. Ciprofloxacin use along with potentially interacting drugs and against contraindications was also another problem indicated in the study.
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Objective To describe the profile of probiotics utilization in hospitalized pneumonia children and evaluate the ef -fectiveness of probiotics in the treatment of pneumonia in hospitalized children combined with antibiotics. Methods Descriptive data a-nalysis was obtained from the medical records in one children′s hospital in one year period. The clinical data including patient charac-teristics, drug prescribed time, drug use duration, and length of stay was reviewed. Ridit analysis was used to compare the data. Re-sults Data of 2 974 children hospitalized for pneumonia was accessed. Antibiotics were prescribed to 99.1 % ( n=2 948) of pa-tients, probiotics were prescribed to 42.1%(n=1 252) of patients, and both antibiotics and probiotics were prescribed to 41.9%(n=1 246 ). The median of the time to start administration of probiotics was the second day of hospitalization and the mode was the first day of hospitalization. For those patients who were prescribed antibiotics combined with probiotics, the median of the duration of ad-ministration of antibiotics before accepting probiotics was 3 days and the mode was 1 day.After administrating probiotics, the median of the duration of accepting of antibiotics was 5 days, the mode was 4 days, and the median and the mode of the duration of administration of probiotics were 4 days.21%(n=626) of all hospitalized patients were administrated anti-diarrheals.The most common age group of them were neonates and infants (82.3%, n=515).The patients with anti-diarrheal who was administrated antibiotics with or with-out probiotics were 585(47.0%), 34(2.0%), respectively (P<0.05).The median of duration of anti-diarrheals in those adminis-trated antibiotics with probiotics was 4 days, the mode was 3 days and the interquartile range was 2-6 days.For those administrated an-tibiotics without probiotics, the median of duration of anti-diarrheals was 3 days, the mode was 1 day and the interquartile range was 1-6 days (P>0.05).The median of the length of stay in those administrated antibiotics with probiotics was 7 days, the mode was 6 days and the interquartile range was 6-9 days.For those administrated antibiotics without probiotics, the median and the mode of the length of stay were 7 days and the interquartile range was 6-9 days(P>0.05).Conclusion The time of starting to administrate probiotics was mainly within 2 days combined with antibiotics. The aim of prescribed probiotics was prevention of antibiotic-associated diarrhea. There was no significant difference in the duration of the following antibiotic therapy, the duration of anti-diarrhea therapy, the length of stay between those administrated antibiotics combination with or without probiotics.
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Background: Assessment of antimicrobial use can be performed by evaluating their use. Drug use evaluation is a performance improvement method that focuses on evaluation and improvement of drug use processes to achieve optimal patient outcomes. The objective of this study was to evaluate the rational use of ceftriaxone in Medical ward of Dessie referral Hospital, Dessie-Ethiopia. Methods: Retrospective systematic study was used to assess rational use of ceftriaxone. The study was conducted by reviewing medication records of 316 patients, who received ceftriaxone during hospitalization at Medical ward of Dessie referral Hospital from December 30, 2011 to January, 2013. A systematic sampling method was used to select inpatient prescriptions in this ward with ceftriaxone and patient cards were located based on the medical record number on the prescription papers. Data was collected by using structured format and evaluated against WHO criteria for drug use evaluation as per standard treatment guideline of Ethiopia. Results: Most patients were dosed as 2 g/day (79.4%). The duration of therapy was found to be high in the range 2-7 days (51.69%). Ceftriaxone was mainly used as pneumonia treatment (38.8%). Maintenance fluids were the most commonly co-administered medications with a frequency of 62.16%. The use of ceftriaxone was appropriate only in 170 cases (55.8%) for the justification of use. Most of inappropriate uses were seen in terms of duration during treatment of pneumonia followed by frequency for the treatment of meningitis. Consistency of prescriber to the national standard treatment guideline was found to be low. Conclusions: To improve rational use and prevent the development of resistance; prescribers should adhere to the national standard treatment guideline. Intensification of short term trainings and antibiotic control systems are some of the possible solutions the hospital has to do.ceftriaxone therapy does not meet the current STG of Ethiopia.
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This study analyzed the use pattern of imipenem following the restructuring of the antimicrobial audit system at a University Hospital. It was an observational study before and after the restructuring of the antimicrobial audit system in a University Hospital from May to August and then from September to December 2006. The criteria of the rational use of imipenem were obtained from a non-systematic revision of the literature. The collection of data on the general characteristics and clinical state of the patient, the infection and the established therapy was carried out in a previously tested instrument. Data was recorded, revised and analyzed in a database built with the software SPSS® for Windows® PC, version 10.0. The statistical analysis had a descriptive character: frequencies, mean, median and standard deviation. No differences were encountered in relation to the appropriate indication, consumption and clinical outcomes of patients. However, there was a reduction of 4 to 1 (75.0 percent) in the number of associations with spectrum superposition and an increase of 4 to 8 (50.0 percent) in the change of therapy. The restructuring of the antimicrobial audit system in the studied hospital did not reflect significantly the increase of the appropriate indication of imipenem. It contributed, however, to the reduction of the inappropriate associations of this antibiotic and to changes of therapy, without, however, compromising the quality of services rendered to patients.
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Female , Humans , Male , Middle Aged , Anti-Bacterial Agents/therapeutic use , Drug Utilization Review/methods , Imipenem/therapeutic use , Brazil , Hospitals, University , Medical AuditABSTRACT
BACKGROUND: To evaluate the appropriateness of intravenous (IV) ciprofloxacin usage in university hospitals in Korea. MATERIALS AND METHODS: We prospectively evaluated the appropriateness of drug usage in 290 consecutive adult patients who received IV ciprofloxacin in eight teaching hospitals during the period from September 25, 2003 to November 15, 2003. Drug use evaluation (DUE) in this study was based on the modified standard by the American Society of Hospital Pharmacy with regard to the justification of drug use, critical and process indications, complications, and outcome measures. RESULTS: Average age of the patients was 54 years. The use of IV ciprofloxacin was appropriate only in 33 cases (26.9%). Common reasons for inappropriate use of IV ciprofloxacin include perioperative uses or prophylactic injection before urologic procedures, and empirical therapy for febrile episodes. Most of the "critical indications" and "process indications" showed high rate of appropriateness (82.4-100%). However, the rate of taking culture and sensitivity test before (73.8%) and during ciprofloxacin use (68.6%) were low. Complications with ciprofloxacin use were rare. In 93.3% of cases, ciprofloxacin treatment was clinically effective. CONCLUSION: Use of intravenous ciprofloxacin is frequently inappropriate in tertiary care hospitals in Korea. Implementation of education program and antibiotic control system is critical in improving the appropriateness of antimicrobial use.
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Adult , Humans , Ciprofloxacin , Education , Hospitals, Teaching , Hospitals, University , Korea , Outcome Assessment, Health Care , Pharmacy , Prospective Studies , Tertiary HealthcareABSTRACT
BACKGROUND: To evaluate the appropriateness of intravenous (IV) ciprofloxacin usage in university hospitals in Korea. MATERIALS AND METHODS: We prospectively evaluated the appropriateness of drug usage in 290 consecutive adult patients who received IV ciprofloxacin in eight teaching hospitals during the period from September 25, 2003 to November 15, 2003. Drug use evaluation (DUE) in this study was based on the modified standard by the American Society of Hospital Pharmacy with regard to the justification of drug use, critical and process indications, complications, and outcome measures. RESULTS: Average age of the patients was 54 years. The use of IV ciprofloxacin was appropriate only in 33 cases (26.9%). Common reasons for inappropriate use of IV ciprofloxacin include perioperative uses or prophylactic injection before urologic procedures, and empirical therapy for febrile episodes. Most of the "critical indications" and "process indications" showed high rate of appropriateness (82.4-100%). However, the rate of taking culture and sensitivity test before (73.8%) and during ciprofloxacin use (68.6%) were low. Complications with ciprofloxacin use were rare. In 93.3% of cases, ciprofloxacin treatment was clinically effective. CONCLUSION: Use of intravenous ciprofloxacin is frequently inappropriate in tertiary care hospitals in Korea. Implementation of education program and antibiotic control system is critical in improving the appropriateness of antimicrobial use.