Appropriate use of carbapenems in the Besançon university hospital

Jary, F.; Kaiser, J.; Hénon, T.; Leroy, J.; Patry, I.; Blasco, Gilles; Limat, Samuel

doi:10.1016/j.medmal.2012.07.004

Cited by 18 publications

(12 citation statements)

References 15 publications

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“…This was in agree with a study conducted to evaluate the use of carbapenem in a French University hospital by Jary et al, which found60% of meropenem was prescribed empirically [20].…”

Section: Discussionsupporting

confidence: 93%

Evaluation of Meropenem Utilization in Intensive Care Unit in Sudan

Sanhoury¹,

Eldalo²

2016

Int J Clin Pharmacol Pharmacother

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Background: Antimicrobial agents are one of the frequently utilized drug classes in anIntensive Care Unit setting (ICU). Objective: was to evaluate the meropenem utilization among Sudanese patients in the ICU in military hospital. Method: A retrospective study was carried out in the ICU in military hospital during the period from September 2014 to February 2015.A well designed pretested questionnaire was used to collect the data. The collected data was analyzed using SPSS software version 17. Results: A total of 135 patients' files were encountered. The results showed that, no culture was done for any patient before meropenem used. Overall 80% of meropenem was prescribed empirically, Out of the patients who's having meropenem, 7.41% were diagnosed pneumonias and 12.59% septicemia. Creatinine clearance was ranged from 50 to137 ml/min in a total 40.8% of patients used meropenem, so they didn't need dose adjustment, while 59.2 % of them needed dose adjustment since their creatinine clearance was range from 50 to 10 ml/min. The therapeutic response was high 65.2% among the patients who using meropenem, while only 14.8% of them were not cured by this antibiotic. The dose was 0.5-1 gm meropenem twelve hourly for most of patients. Conclusion: Meropenem use in ICU appears to be inconsistent with evidence based assessment criteria. The most evident inappropriateness was observed in empirical therapy. The study also detected other potential problematic areas where concordance with standard guidelines is yet to be achieved. Continuous medical education, functional drug and therapeutic committees and regular drug utilization evaluation programs could help in accomplishing the milestone of rational medication use.

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“…This was in agree with a study conducted to evaluate the use of carbapenem in a French University hospital by Jary et al, which found60% of meropenem was prescribed empirically [20].…”

Section: Discussionsupporting

confidence: 93%

Evaluation of Meropenem Utilization in Intensive Care Unit in Sudan

Sanhoury¹,

Eldalo²

2016

Int J Clin Pharmacol Pharmacother

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“…6 Ciprofloxacin, vancomycin and imipenem were utilized the most in a drug use evaluation in an Iranian hospital, while Imipenem comprised 95% of all carbapenem prescriptions in yet another study. 7,8 Present study finding reveals that the restrictive measures put in place by the hospital to limit the use of carbapenems especially meropenem have not succeeded. Among the beta-lactam antibiotics, carbapenems possess the broadest spectrum of activity and are meant to be used as last-line agents or when patients with infections become gravely ill or are suspected of harboring resistant bacteria.…”

Section: Discussionmentioning

confidence: 72%

Broad spectrum antibiotic use among in-patients at a hospital in Nairobi, Kenya

Mariita

Chirima

Maina³

2018

Int J Basic Clin Pharmacol

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Background: Antimicrobial resistance is an increasingly serious threat to global public health. While the use of antibiotics is an important contributing factor, there are gaps regarding this in our region. This study aimed to describe the use of nine broad spectrum antibiotics among in-patients of The Nairobi Hospital (TNH) so as to identify opportunities for quality improvement.Methods: This was a retrospective review of the use of meropenem, ertapenem, imipenem, cefepime, piperacillin, gentamicin, amikacin, vancomycin and teicoplanin among in-patients of TNH from 1st January 2018 to 31st March 2018. Demographic and clinical data of all in-patients who were prescribed these antibiotics during the study period were retrieved from patient files.Results: There were 301 study participants with a median age (range) of 30years (1day-74years), of whom 161 (53.5%) were male. More than half of the participants were admitted for less than one week and had at least one co-morbidity. Meropenem was the most commonly prescribed study antibiotic 123 (40.9%) followed by amikacin 89 (29.6%). Respiratory tract infections 125 (41.5%) were the predominant indications. Meropenem had the longest mean duration of administration, 6.5days while the aminoglycosides were administered for a relatively shorter duration of about 4.8days. Cultures were done on 187 (62.1%) patients though it is only samples of 45 patients that grew an organism, E. coli and Klebsiella sp being the most frequently isolated organisms.Conclusions: There’s a need to strongly intensify implementation of restriction strategies for Meropenem use and introduction of education programs on antimicrobial stewardship targeting all prescribers.

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“…De-escalation is a part of antimicrobial stewardship that means shifting from a broad-spectrum antibiotic to a narrow spectrum one. [ 38 39 ] The Australian study which was done in 2005–2008 showed that the antimicrobial stewardship led to increase in the sensitivity of Gram-positive and Gram-negative microorganisms. [ 40 ]…”

Section: Discussionmentioning

confidence: 99%