Ceftriaxone and cefotaxime use in Victorian hospitals

Robertson, Marcus; Dartnell, Jonathan; Korman, Tony M.; Ioannides‐Demos, Lisa L; Kirsa, Sue; Lord, Julie; Munafo, Liliana; Byrnes, Graham

doi:10.5694/j.1326-5377.2002.tb04549.x

Cited by 39 publications

(30 citation statements)

References 5 publications

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“…In this study, 114 patients (16%) satisfied these criteria; however, 44% of patients were prescribed ceftriaxone or cefotaxime. This result is consistent with previous Australian studies, which also demonstrated a high level of third‐generation cephalosporin use outside Guidelines recommendations 12 , 20 …”

Section: Discussionsupporting

confidence: 93%

Empiric management of community‐acquired pneumonia in Australian emergency departments

Maxwell¹,

McIntosh²,

Pulver

et al. 2005

Medical Journal of Australia

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Objective: To describe empiric community‐acquired pneumonia (CAP) management in Australian hospital emergency departments (EDs) and evaluate this against national guidelines, including use of the pneumonia severity index and antibiotic selection. Design: A multicentre, cross‐sectional, retrospective audit, April 2003 to February 2005. Setting: 37 Australian hospitals: 22 principal referral hospitals, six large major city hospitals, four large regional hospitals, four medium hospitals and one private hospital. Participants: Adult patients with a diagnosis of CAP made in the ED. Data on 20 consecutive CAP ED presentations were collected in participating hospitals. Outcome measures: Documented use of the pneumonia severity index, initial antibiotic therapy prescribed in the ED, average length of stay, inpatient mortality, and concordance with national guidelines. Results: 691 CAP presentations were included. Pneumonia severity index use was documented in 5% of cases. Antibiotic therapy covering common bacterial causes of CAP was prescribed in 67% of presentations, although overall concordance with national guidelines was 18%. Antibiotic prescribing was discordant due to inadequate empiric antimicrobial cover, allergy status (including contraindication to penicillin), inappropriate route of administration and/or inappropriate antibiotic choice according to recommendations. There was no significant difference between concordant and discordant antibiotic prescribing episodes in average length of stay (5.0 v 5.7 days; P = 0.22) or inpatient mortality (1.6% v 4.1%; χ2 = 1.82; P = 0.18). Conclusions: Antibiotic therapy for CAP prescribed in Australian EDs varied. Concordance with national CAP guidelines was generally low. Targeted interventions are required to improve concordance.

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Section: Discussionsupporting

confidence: 93%

Empiric management of community‐acquired pneumonia in Australian emergency departments

Maxwell¹,

McIntosh²,

Pulver

et al. 2005

Medical Journal of Australia

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“…It is interesting to note that twice‐daily administration accounted for 76.9% of the cases and at the same time, frequency of administration was found to be the leading cause of inappropriate ceftriaxone use which is observed in 78.3% of the cases. This finding was similar in the study done in Addis Ababa and USA …”

Section: Discussionsupporting

confidence: 91%

Prospective evaluation of Ceftriaxone use in medical and emergency wards of Gondar university referral hospital, Ethiopia

Ayele

Gebresillassie

Erku

et al. 2018

Pharmacology Res & Perspec

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Ceftriaxone is among the most commonly utilized antibiotics owing to its high potency, wide spectrum of activity, and low risk of toxicity. It is used to treat different types of bacterial infections including pneumonia, bone infections, abdominal infections, Skin and soft tissue infections, urinary tract infections. However, evidence around the globe shows the misuse of Ceftriaxone. This study aimed at evaluating the appropriateness of ceftriaxone use in medical and emergency wards of Gondar university referral hospital (GURH), Northwest Ethiopia. A prospective, cross‐sectional study design was employed to evaluate the use of ceftriaxone. The medical records of patients who received ceftriaxone were reviewed prospectively between January 1 and March 30, 2017. Appropriateness of ceftriaxone use was evaluated as per the protocol developed from current treatment guidelines. A total of 390 patients’ medical records were reviewed. The utilization rate of ceftriaxone was found to be high with a point prevalence of 59%. Ceftriaxone was empirically used in 79.5% of cases. The most common indications of Ceftriaxone were respiratory tract infections (29.3%), central nervous system infections (24.1%), and prophylactic indications (16.4%). The mean duration of ceftriaxone therapy in our study was 11.47 days, with a range of 1‐52 days. More than two‐thirds (80.2%) of ceftriaxone use were found to be inappropriate and majority of unjustified ceftriaxone use emanated from inappropriate frequency of administration (78.3%), absence of culture and sensitivity test (68.7%), and duration of therapy (47%). Empiric treatment with ceftriaxone and the presence of coadministered drugs was significantly associated with its inappropriate use. The present study revealed a very high rate of inappropriate use of ceftriaxone which may potentially lead to emergence of drug‐resistant microorganisms and ultimately exposes the patient to treatment failure and increased cost of therapy.

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“…In our study, the prevalence rate of use of 3GCs was lower than the reported rate of 43 per 1000 admissions for ceftriaxone in 51 Victorian Hospitals in Australia of which 82% was prescribed as empirical treatment [19]. Our data reveals extensive overall inappropriate use of these drugs (62%) at the POSGH in Trinidad, with a rate that is higher than an earlier literature report (31%) [20].…”

Section: Discussioncontrasting

confidence: 67%

Third generation cephalosporin use in a tertiary hospital in Port of Spain, Trinidad: need for an antibiotic policy

Pereira

Phillips²,

Ramlal³

et al. 2004

BMC Infect Dis

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Background: Tertiary care hospitals are a potential source for development and spread of bacterial resistance being in the loop to receive outpatients and referrals from community nursing homes and hospitals. The liberal use of third-generation cephalosporins (3GCs) in these hospitals has been associated with the emergence of extended-spectrum beta-lactamases (ESBLs) presenting concerns for bacterial resistance in therapeutics. We studied the 3GC utilization in a tertiary care teaching hospital, in warded patients (medical, surgical, gynaecology, orthopedic) prescribed these drugs.

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Ceftriaxone and cefotaxime use in Victorian hospitals

Cited by 39 publications

References 5 publications

Empiric management of community‐acquired pneumonia in Australian emergency departments

Empiric management of community‐acquired pneumonia in Australian emergency departments

Prospective evaluation of Ceftriaxone use in medical and emergency wards of Gondar university referral hospital, Ethiopia

Third generation cephalosporin use in a tertiary hospital in Port of Spain, Trinidad: need for an antibiotic policy

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