Cephalosporins Usage in Hospitals Before and After Iran’s Health Reform Plan
Abstract
Background: This study aimed to investigate the usage patterns of some parenteral cephalosporins in hospitals affiliated to Shahid Beheshti University of Medical Sciences. The study design consisted of one year before and one year after the implementation of Health Reform Plan (HRP) in Iran.Methods: The data were collected from 6 university hospitals, including Taleghani, Mofid, Akhtar, Loghman Hakim, Shohadaye Tajrish, and Mahdieh hospitals from 2014 to 2015. The obtained data were analyzed using the GraphPad Prism software. The total consumption of parenteral cephalosporins in the 6 hospitals was expressed in Defined Daily Dose (DDD) per 100 Bed Days (BD).Results: DDD/100 BD increased from 149.132 to 149.454 DDD/100 one year following the implementation of HRP. This data indicates that the consumption of cefazolin, cefotaxime, ceftizoxime, ceftriaxone, ceftazidime, and cefepime were not significantly changed. Although lower doses (g/d) of ceftizoxime and cefotaxime were used, compared to the standard doses in hospitals, the consumed dose of ceftriaxone (g/d) was significantly higher than the standard DDD.Conclusion: The obtained results suggest that the HRP was probably not effective in improving irrational antibiotic consumption in Iran. Thus, it is necessary to employ stewardship programs to control such irrational usage. This program should be conducted under the supervision of clinical pharmacists and infectious disease specialists.Amani F, Mohammadi S, Shaker A and Shahbazzadegan S. Study of Arbitrary Drug Use among Students in Universities of Ardabil City in 2010. Journal of Ardabil University of Medical Sciences 2011; 11:201-7.
Amani F, Mohammadi S, Shaker A and Shahbazzadegan S. Study of Arbitrary Drug Use among Students in Universities of Ardabil City in 2010. arumsj 2011; 11:201-7.
Llor C and Bjerrum L. Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem. Therapeutic Advances in Drug Safety 2014; 5:229-41.
Alikhani A, Shahamat M and Ghaffarian Shirazi H. Survey on Antibiotic Prescription for under 14 Years Old Outpatient Children in General Practitioner Prescriptions in Yasuj. Armaghane danesh 2006; 10:83-91.
Hassani S, Eshraghi A, Hematian F, Taheri M and Sahraei Z. Role of Clinical Pharmacists in Early Detection, Reporting and Prevention of Medication Errors in a Medical Ward. Journal of Pharmaceutical Care 2017; 3:54-60.
Hajebi G, Mortazai S and Goodarzi J. A survey of consumption pattern of antibiotics in Taleghani Hospital. Research in Medicine 2005; 29:157-64.
Teng L, Xin HW, Blix HS and Tsutani K. Review of the use of defined daily dose concept in drug utilisation research in China. Pharmacoepidemiol Drug Saf 2012; 21:1118-24.
khoshdel A and Panahandeh G. The pattern of antimicrobial utilization in patients of pediatric wards in Hajar hospital, Shahrekord, Iran in 2009-2010. Journal of Shahrekord Uuniversity of Medical Sciences 2012; 14:54-62.
Kumar SG, Adithan C, Harish BN, Sujatha S, Roy G and Malini A. Antimicrobial resistance in India: A review. Journal of Natural Science, Biology, and Medicine 2013; 4:286-91.
Ansari F. Utilization review of systemic antiinfective agents in a teaching hospital in Tehran, Iran. Eur J Clin Pharmacol 2001; 57:541-6.
Evans SJW. Pharmacoepidemiology. British Journal of Clinical Pharmacology 2012; 73:973-8.
Noubarani M, Shafizade F and Hajikarim B. Antibiotic Prescription Pattern in Vali-Asr Hospital Units of Zanjan City. Journal of Zanjan University of Medical Sciences 2016; 24:122-9.
Ebrahimzadeh MA, Shokrzadeh M and Ramezani A. Utilization pattern of antibiotics in different wards of specialized Sari Emam University Hospital in Iran. Pak J Biol Sci 2008; 11:275-9.
Fridkin SK, Edwards JR, Courval JM, Hill H, Tenover FC, Lawton R, et al. The effect of vancomycin and third-generation cephalosporins on prevalence of vancomycin-resistant enterococci in 126 U.S. adult intensive care units. Ann Intern Med 2001; 135:175-83.
Sistanizad M, Kouchek M, Miri M, Goharani R, Solouki M, Ayazkhoo L, et al. Carbapenem Restriction and its Effect on Bacterial Resistance in an Intensive Care unit of a Teaching Hospital. Iran J Pharm Res 2013; 12:503-9.
Pujol M, Delgado O, Puigventos F, Corzo JE, Cercenado E and Martinez JA. Evaluation of new antimicrobials for the hospital formulary. Policies restricting antibiotic use in hospitals. Enferm Infecc Microbiol Clin 2013; 31 Suppl 4:45-50.
Apisarnthanarak A, Danchaivijitr S, Khawcharoenporn T, Limsrivilai J, Warachan B, Bailey TC, et al. Effectiveness of education and an antibiotic-control program in a tertiary care hospital in Thailand. Clin Infect Dis 2006; 42:768-75.
Arnold SR and Straus SE. Interventions to improve antibiotic prescribing practices in ambulatory care. Cochrane Database Syst Rev 2005; Cd003539.
Shalit I, Low M, Levy E, Chowers M, Zimhony O, Riesenberg K, et al. Antibiotic use in 26 departments of internal medicine in 6 general hospitals in Israel: variability and contributing factors. J Antimicrob Chemother 2008; 62:196-204.
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Issue | Vol 3 No 3/4 (2017) | |
Section | Original Article(s) | |
Keywords | ||
Rational use of drug Antibiotics Cephalosporins Defined Daily Dose Health Reform Plan |
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