Development of a Drug Evaluation System in Patients with Kidney Disease, Outpatient Dispensing Work at Nakhonphanom Hospital

Abstract

Objective: Renal function disorders may affect the drug excretion in patients with chronic kidney disease, in case of there is no an appropriate monitoring. The outpatient dispensary room, Nakhonphanom hospital improves the using of 13 items of oral antibiotic drugs, as the guideline for dose adjustment in patients with chronic kidney disease, appropriately.

Materials and methods: This is a descriptive study of the oral antibiotic drugs use, comparison of the number of antibiotic drugs use and cost, before and after dose adjustment in patients with chronic kidney disease at outpatient dispensary room, Nakhonphanom hospital. The data of 13 items of oral antibiotic drugs use were collected between 1st January, 2019 to 31st December 2019.

Results: The study found that the most patients who were serviced at Nakhonphanom hospital before and after appropriate dose adjustment of oral antibiotic drugs were female, 52.6% and 54.1%, respectively. Comparison of the number of antibiotic drugs use before and after appropriate dose adjustment as follow, amoxicillin /clavulanic acid (500/125 mg), before and after administration guidelines were 4,324 times (74.38%) and 5,425 times (92.96%), respectively, statistically significant difference (p <0.001). Azithromycin, before and after, were 691 times (79.80%) and 593 times (86.95%), respectively, statistically significant difference (p=0.025). Norfloxacin, before 2,032 times (88.62%) and after 1,927 times (97.37%), statistically significant difference (p = 0.004). Considering the value of oral antibiotic drug after rules setting in the appropriate adaptation for patients with chronic kidney disease found that cost reduction between before and after dose adjustment were 111.71 ± 186.9 baht and 104.43 ± 179.4 baht, respectively, which were not statistically significant difference (p = 0.164).

Conclusion: Outpatient dispensary work, Nakhonphanom hospital improved the use of 13 items of oral antibiotic drugs. The list of drug adjustment guidelines has been proposed in the PCT board, which physicians followed the guidelines and can reduce the cost of antibiotic drugs.