Carbapenems Utilization Evaluation in Neutropenic Patients of a Teaching Hospital
Background: Carbapenems is frequently prescribed for treatment or prophylaxis in neutropenic patients. It is cleared that antimicrobial misuse can cause poor patient outcomes, through raise of antibiotic resistance, increased adverse events, and prolonged length of hospital stay. Objectives: to evaluate the rational use of Imipenem- Cilastatin and Meropenem for empirical antibacterial therapy in neutropenic patients based on IDSA guideline. Methods: through this cross-sectional study, we assessed the appropriateness of administration of Carbapenems in neutropenic patients admitted in hematology–oncology and bone marrow transplant wards in Namazee hospital, Shiraz, Iran, from March 2012 to May 2013. Results: Total of 90 patients were enrolled. Drug therapy duration was appropriate in 69.6% of Imipenem-Cilastatin and 75% of Meropenem groups. Sampling time of culture was appropriated in 59.1% of Imipenem-Cilastatin and 78.3% of Meropenem group, interval of drug administration was correct in 74.5% at initiation and 79.4% during therapy in Imipenem-Cilastatin group. For dosing these values were 74.5% and 72.2%, respectively. These values were evaluated in patients who received Meropenem too, interval was correct in 89.5% at initiation and 90.3% during therapy, dosing was correct in 12.3% either at initiation and during therapy. Conclusion: These finding suggest that attention to correct dose, correct interval, renal dose adjustment, logical indication for administration of carbapenem should be considered by health care system
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