Drug use evaluation of cefepime in the first affiliated hospital of Bengbu medical college: a retrospective and prospective analysis

BMC Infectious Diseases

Yu Meiling²  Yuan HaoYu¹  Liu Yan²  Sang Ran²  Ding Feng²  Shi Qingping³ 

[1] HeGongYe 416 Hospital, Chengdu, 610051, China;Department of Pharmacy, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, China;College of Pharmacy, Bengbu Medical College, Bengbu, 233004, China

关键词: Drug use evaluation;    Cost-effectiveness;    Clinical pharmacy;    Cefepime;   

Others  :  1149041
DOI  :  10.1186/1471-2334-13-160

 received in 2012-07-15, accepted in 2013-03-25,  发布年份 2013

【 摘 要 】

Background

Cefepime is a fourth generation cephalosporin antimicrobial. Its extended antimicrobial activity and infrequent tendency to engender resistance make it popular for the treatment of infections. However, proper use of cefepime has not been studied adequately. In this study, we used a retrospective cohort and a prospective cohort to evaluate the usage pattern, adverse effects and cost-effectiveness of cefepime by conducting a drug use evaluation (DUE) program in the First Affiliated Hospital of Bengbu Medical College, Anhui, China.

Methods

The DUE criteria for cefepime were established by applying literature review and expert consultation, an effective method to promote interventions that will improve patient outcomes and the cost-effectiveness of drug therapy. According to the criteria, we performed a cross-sectional retrospective (cycle A) study on 96 hospitalized patients who received cefepime treatment and a prospective (cycle B) study on 111 hospitalized patients with cefepime treatment intervention. After identifying problems with usage and completing a cefepime use evaluation for cycle A, 2 months of educational intervention among professionals were given and a more effective and rational system of cefepime use was set up. During the 2 months, the lectures were arranged and attendance of prescribers was required.

Results

The data from cycle A showed that the biggest problem was irrational prescription of cefepime; bacterial culture and drug sensitivity tests for cefepime were also not carried out. Following 2 months of educational intervention among professionals, the results for cycle B showed that the correct indication rate was 94.59%, compared with 84.38% in cycle A. Use of bacterial culture and sensitivity tests also improved, by 88.29% in cycle B compared with 65.22% in cycle A. Compared with cycle A, the significantly improved items (P < 0.05) in cycle B were blood examination, liver function monitoring, renal function monitoring, dose and duration, dosing frequency and correct medication combinations.

Conclusions

Cefepime can be used appropriately for the right indications and in a cost-effective way for the majority of patients through educational intervention, including the special precautions that must be followed for appropriate dosing frequency and duration. DUE programs will become one model of hospital pharmacy care and part of the plan for continuous improvements to the quality of health care in China.

【 授权许可】

   
2013 Qingping et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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