Evaluation of prophylactic antibiotic administration at the surgical ward of a major referral hospital, Islamic Republic of Iran

We evaluated the appropriateness of antibiotic prophylaxis administered before surgery at a major referral hospital in Shiraz, against the American Society of Hospital Pharmacists [ASHP] guidelines. Data on surgical procedure, choice of antibiotic and administration were gathered for all surgeries performed on hospitalized patients during 15 days in March 2010, Of 155 patients included in the analysis, 98% received prophylactic antibiotic before surgery; according to ASHP guidelines, prophylaxis was needed in only 106 [68.4%]. Of these 106, only 8 patients received the correct antibiotic regimen. The commonest regimens administered were cefazolin + gentamicin [47.6%], cefazolin [20.5%] and cefuroxime [8.5%]. Antibiotic prophylaxis was continued in 83% of cases, while this was necessary in only 37%. In only 1 surgical procedure were all evaluated parameters correct

drug utilization research on aminophylline/ theophylline in ali-asghar hospital, shiraz, southern iran

Drug utilization research [DUR] is an effective program to identify variability in drug use and to support interventions that will improve patient outcomes. The appropriate use of aminophylline/theophylline was evaluated in Shiraz, southern Iran. A prospective DUR study was conducted in Ali-Asghar Hospital from April 2005 to April 2007. All inpatient cases of asthma or COPD who were started on IV loading dose of aminophylline were included in the study. A blood sample was provided from the patients at steady state condition just before the next dose, in order to determine the trough serum concentration of the drug. Demographic characteristics of patients, along with clinical and paraclinical findings, lab data, drug history, and adverse drug events were recorded using their files and a face to face interview. One hundred patients were enrolled among them, 57% [n=57] were female and 43% [n=43] were male. The age range was 16-90 years with mean age +/- SD of 65.63 +/- 14.7. Diagnosis was asthma in 46% and COPD in 54% of patients. Theophylline serum concentration range was 0-37 meg/ml [7.94 +/- 5.4]. Ninety eight percent of patients had at least one adverse event due to aminophyline or theo-phylline use. 14 items were evaluated for aminophylline/theophyline administration and compared to a standard guideline. The mean score for 100 patients included in the study was 8 out of 14. The most considerable problem in aminophylline/theophylline usage in our hospital was ignorance to the important role of pharmacokinetics in optimizing aminophylline/theophylline therapeutic response and minimizing ADEs and the cost of hospitalization. Training of the healthcare providers is recommended. Performing population pharmacokinetic studies will be a good guidance for improving aminophylline/theophylline usage in our population

Vancomycin use in a large teaching hospital in Shiraz, Islamic Republic of Iran, 2003

We investigated adherence to the Hospital Infection Control Practice Advisory Committee [HICPAC] guidelines on vancomycin prescription in a large university-affiliated hospital in Shiraz. From August to December 2003, 200 hospitalized patients received vancomycin. For only 12 [6%] of these patients was vancomycin prescribed appropriately according to HICPAC guidelines. The main reasons why vancomycin use did not comply with HICPAC recommendations were: surgical prophylaxis in patients with negative cultures for resistant Gram-positive organisms, no investigation of vancomycin serum levels in patients receiving > 48 hours of vancomycin, vancomycin serum levels not repeated in patients receiving > 1 week of vancomycin, no appropriate adjustment of dosage with respect to serum levels in patients receiving vancomycin