Drug Utilization Evaluation of Cefoperazone/Sulbactam in a Community Hospital in Kalasin Province
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Abstract
Objective: To evaluate the utilization of cefoperazone/sulbactam (C/S) in a community hospital in Kalasin province in terms of prescribing pattern, treatment outcomes and adverse drug events. Method: This study was a descriptive study of concurrent drug utilization review. The data were collected from medical records of patients receiving C/S between October 1st, 2014 and September 30th, 2015. The researcher reviewed C/S utilization according to the criteria approved by the Pharmacy and Therapeutic Committee (PTC). Results: During study period, C/S was prescribed to 32 patients. The use of C/S in 29 patients (90.63%) was an empirical therapy. The most common site of infection found was lungs (20 patients or 62.50%). Prescribing of C/S in 25 patients (78.12%) was in line with the PTC approved criteria. There were 4 patients (12.50%) treated with inappropriate C/S doses and 3 patients (9.37%) were not monitored for the renal function after C/S use for more than 7 days. For the outcomes of C/S therapy, 13 patients (40.63%) were improved or cured, 6 elderly patients (18.75%) died with comorbid conditions, the C/S prescriptions for 3 patients (9.37%) were switched to other antibiotics, 3 patients (9.37%) were referred to a General hospital, and thrombocytopenia was found in 2 patients (6.25%). Total C/S cost was 85,827 baht (2682 baht per patient). Cost of C/S use not satisfying the criteria and with no improvement of patients was 7,380 baht (8.59% of total expenditure on C/S). Conclusion: The appropriateness of C/S use in the hospital was at a moderate level. The hospital should establish guidelines for using C/S by requiring the monitoring of renal and liver functions in patients treated with C/S for longer than 7 days, and administration of vitamin K for prevention of lowering platelets. Moreover, education to health care professionals should be provided for promoting the strict use of the drugs according to the criteria. If the prescribing inconsistent to the criteria was identified, pharmacists should inform alert prescribers and monitor the outcomes of the alert. The hospital should conduct an ongoing C/S use evaluation.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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