Combination chemotherapy concurrent with radiation plus adjuvant chemotherapy has demonstrated better survival rates as compared to standard cisplatin chemoradiation and ongoing Phase III trials would eventually confirm these findings. Gemcitabine and paclitaxel are the most evaluated agents added to cisplatin chemoradiation and in the adjuvant setting. Further survival gains combining classical cytotoxics will be limited by toxicity, hence, novel antitumor drugs; in particular angiogenesis inhibitors must be evaluated to increase the efficacy of current chemoradiation regimens. In advanced disease, modest survival gains were recently achieved with cisplatin doublets as compared to single agent cisplatin. Bevacizumab added to standard chemotherapy has for the first time demonstrated that targeted agents are valuable in the treatment of advanced cervical cancer. Ongoing Phase III trials for cervical cancer are limited reflecting the shortage of promising molecules and the need to increase research efforts for this disease.

Background The restricted use policy was established to assist the correct use of medicines. The Pharmacy and Infections Committee agreed to authorise indications for use that accorded with treatment protocols and clinical practice guidelines; once these prescribing rules were decided, the next step was pharmaceutical validation of the prescriptions. Computer-assisted prescribing provides information to prescribers and facilitates checking. Purpose To assess the usefulness of computer-assisted prescribing in restricted-use drugs in our hospital. Materials and methods The PRESEL application is used for electronic prescribing. Restricted drugs and the indications for their authorised use were defined in PRESEL. When prescribing these medicines it was necessary to type the clinical indication; at the same time authorised indications were shown on screen as advice. During the validation process the pharmacist could accept the prescription or not, and record the prescribing indication in PRESEL. At the time of this study, our hospital used computer-assisted prescribing for 49% of surgical beds. Prescriptions written between June 2010 and May 2011 were studied. Information about the restricted-use drugs prescribed, authorised indications, and clinical unit prescriptions were collected and analysed. Results During the study period, there were 50,990 electronic prescriptions for 5,210 patients. 113 restricted-drug prescriptions for 10 different drugs were recorded. None of them was rejected. The antimycotics posaconazole and micafungin were the most prescribed (37%), followed by the antibiotics tigecycline and linezolid (28%). The most frequent indication for antimycotics was ‘prophylaxis of fungal infections in immunocompromised haematopoietic stem cell transplantation recipients’; for antibiotics the most frequent was ‘complicated intra-abdominal infection’. The majority of prescriptions were written on the Haematology (65.49%), Infectious Diseases (7.96%), Surgery (5.31%) and Neurology (5.31%) wards. Conclusions In our hospital antifungals and antibiotics are most common restricted-use drugs. Haematology and Infectious clinical services are the main prescribers. Computer-assisted prescription applications are useful to set restrictions and to check if prescriptions comply.

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