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Drug Use Evaluation of Antibiotics in a Pediatric Teaching Hospital

Published online by Cambridge University Press:  02 January 2015

Kelley R. Lee ,
Robert J. Leggiadro  and
Kelly J. Burch
Kelley R. Lee*
Affiliation:
Le Bonheur Children’s Medical Center and University of Tennessee, Memphis, Tennessee
Robert J. Leggiadro
Affiliation:
Le Bonheur Children’s Medical Center and University of Tennessee, Memphis, Tennessee
Kelly J. Burch
Affiliation:
Le Bonheur Children’s Medical Center and University of Tennessee, Memphis, Tennessee
*
Department of Pharmacy, Le Bonheur Children’s Medical Center, 848 Adams, Memphis, TN 38103
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Abstract

Objective:

To determine the incidence and type of antibiotic use variances at our institution.

Design:

Inpatient bacterial culture and susceptibility results were reviewed for 1 week per month. Medication administration records were evaluated to determine whether antibiotic selection was appropriate, given the susceptibility of the organism. Process indicators included use of the least costly antibiotic. as well as appropriate dose, interval, and route of administration. The complete medical record was reviewed for all patients if management did not appear to meet criteria.

Setting:

A 225-bed. tertiary-care children’s teaching hospital.

Results:

Thirty-five (8.2%) of 428 patients reviewed over 12 months had a total of 49 variances: failure to treat (3), treatment of contaminant/colonizer (2), use of more costly agent (10), failure to revise therapy (8), inappropriate route (2), inappropriate empiric antibiotic (4), incorrect dose (3), unnecessary multiple antibiotics (6), inappropriate drug (8), and prolonged prophylaxis (3).

Conclusions:

Thirty-five patients with 10 types of variances were identified during the study. Follow-up monitoring will assess the impact of educational efforts on the incidence of variances. Specific problem antibiotics have been identified for further audits.

Type
Beyond Infection Control: The New Hospital Epidemiology
Information
Infection Control & Hospital Epidemiology , Volume 15 , Issue 11 , November 1994 , pp. 710 - 712
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994 

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