Original Article

Drug Utilization Evaluation of Antibiotics in Burn Patients at a Referral Teaching Hospital


Background: Nowadays, due to the irrational and excessive use of antibiotics, antimicrobial resistance has become one of the main concerns of the medical community. Patients with burns are more prone to infections due to the loss of the skin's defense barrier and a weakened immune system. Therefore, proper antibiotic treatment is essential in these patients. In the present study, the rational use of antibiotics in the burn hospital of Imam Mousa Kazem in Isfahan was evaluated. Methods: This prospective cross-sectional descriptive study was performed on 102 hospitalized patients over 9 months (from January to September 2020). Adult burn patients who received at least one antibiotic were included in the study. All required information, including demographic data, the prescribed antibiotic, basis of administration (empiric vs. culture-based), dose and duration of use, microbial culture test, and treatment outcome were recorded in the data collection form by referring to patients’ medical profile and the hospital computer system. Judgments about the accuracy of the indication, dose, and duration of treatment, as well as the need for dose adjustment in renal or hepatic impairment were made using related guidelines and references. Results: Among the 196 antibiotic prescriptions, cefepime (40.3%) was the most frequently used antibiotic, followed by vancomycin (17.9%) and meropenem (16.8%). Most prescriptions were empirical, while the antibiotics were administered based on the microbial culture results only in two cases (1.9%). The indication of use was correct in 52.6% of prescriptions (n = 103), of which 74.8% (n = 77) had correct dose. In addition, in 47 cases (45.6%), the duration of antibiotic therapy was correct. 6.8% of the patients died, 10.75 discharged with the patient's personal consent, and the rest of the them discharged in good condition. Conclusion: Prescribing antibiotics in Imam Moussa Kazem Hospital is associated with many errors in various aspects, including indication, dose, de-escalation, and duration of treatment.

1. World Health O. Drug and therapeutics committees : a practical guide. / authors: Kathleen Holloway (editor), Terry Green. Geneva: World Health Organization; 2003.
2. Truter I. A review of drug utilization studies and methodologies. Jordan Journal of Pharmaceutical Sciences 2008;1(2):91-103.
3. Sachdeva P, Patel B. Drug utilization studies- scope and future perspectives. International Journal of Pharmaceutical and Biological Research 2010;1.
4. Jacob P, Balasubramanian A, Ramalingam K. A review on steps involved in drug utilization review. International Journal of Research in Pharmaceutical Sciences 2020;11:4095-8.
5. Smolle C, Cambiaso-Daniel J, Forbes AA, et al. Recent trends in burn epidemiology worldwide: A systematic review. Burns 2017;43(2):249-57.
6. Hodle AE, Richter KP, Thompson RM. Infection Control Practices in U.S. Burn Units. J Burn Care Res 2006;27(2):142-51.
7. Norbury W, Herndon DN, Tanksley J, Jeschke MG, Finnerty CC. Infection in Burns. Surg Infect (Larchmt) 2016;17(2):250-5.
8. Sipahi OR. Economics of antibiotic resistance. Expert Rev Anti Infect Ther 2008;6(4):523-39.
9. Silva ML, Cargnello C, Aulois-Griot M, Dumartin C. Antibiotic misuse: How to evaluate the costs? Med Mal Infect 2019;49(7):485-94.
10. Adedeji WA. The treasure called antibiotics. Ann Ib Postgrad Med 2016;14(2):56-7.
11. Jeschke MG, van Baar ME, Choudhry MA, Chung KK, Gibran NS, Logsetty S. Burn injury. Nat Rev Dis Primers 2020;6(1):1-25.
12. Church D, Elsayed S, Reid O, Winston B, Lindsay R. Burn wound infections. Clin Microbiol Rev 2006;19(2):403-34.
13. Subcommittee S, Subcommittee A, Committee IPG. ISBI practice guidelines for burn care. Burns 2016;42(5):953-1021.
14. Pruitt BA Jr, McManus AT, Kim SH, Goodwin CW. Burn wound infections: current status. World J Surg 1998 b;22(2):135-45.
15. Lacy C, Armstrong LL, Lipsy RJ. Drug information handbook 1993: Lexi-comp; 1993.
16. Tavallaee M, Fahimi F, Kiani S. Drug‐use patterns in an intensive care unit of a hospital in Iran: An observational prospective study. Int J Pharm Pract 2010;18(6):370-6.
17. Padwal S, Motghare V, Kulkarni M, Jadhav R, Deshmukh V. Drug utilization in burn patients admitted in a wards of a rural tertiary care teaching hospital. Int J Pharmacol Ther 2013;3:20-6.
18. Elyasi S, Ayubi MS, Jannati M, et al. Vancomycin Utilization Evaluation in a Tertiary Teaching Hospital in Mashhad, Iran. J Pharm Care 2018;5(3-4):44-48.
19. Khalighi F, Tamadoni Jahromi S, Seifati SM. Genetic Identification and Determination of Antibiotic Susceptibility Patterns of Pseudomonas spp. Isolated from Burn Unit of Payambar e Azam Hospital. Bandar Abbas Journal of Marine Medicine 2019;1(2):99-109.
20. Forough AS, Hosseini SR, Jabbari S. Antibiotic utilization evaluation of inpatient and outpatient prescriptions in a rural general hospital in Iran. Int J Basic and Clinical Pharmacol 2015;4(3):531-6.
21. Soltani R, Hakamifard A, Mousavi S, Amani Z. Drug Utilization Evaluation of Antibiotics in Intensive Care Units of a Referral Teaching Hospital. J Pharm Care 2021;9(1):31-38.
22. Saleh P, Hamishekar H, Naeimzadeh F, Mikaili S, Osquee HO, Rezaee H. Drug Utilization Evaluation of Two Broad-Spectrum Antimicrobials: Cefepime and Piperacillin/Tazobactam in a Teaching Hospital in Tabriz, Iran. J Pharm Care 2019;7(1-2):21-25.
23. Saleem Z, Saeed H, Hassali MA, et al. Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan: a longitudinal surveillance and implications. Antimicrob Resist Infect Control 2019;8(1):1-7.
24. Al-Maliky GR, Al-Ward MM, Taqi A, Balkhair A, Al-Zakwani I. Evaluation of antibiotic prescribing for adult inpatients at Sultan Qaboos University Hospital, Sultanate of Oman. Eur J Hosp Pharm 2018;25(4):195-9.
IssueVol 10, No 2 (Spring 2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/jpc.v10i2.9977
Drug Utilization Evaluation Anti-Bacterial Agents Burns

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Soltani R, Sajjadi S, Shirani K, Minaiyan M, Saghafi F. Drug Utilization Evaluation of Antibiotics in Burn Patients at a Referral Teaching Hospital. J Pharm Care. 2022;10(2):63-68.