Effect of the Adoption of Metronidazole Injection Formulation on the Use of Meropenem and Tazobactam/piperacillin

Abstract

In Tobu Chiiki hospital meropenem (MEPM) and tazobactam/piperacillin (TAZ/PIPC) have been selected as initial treatment for severe intra-abdominal infections, and there have been some cases that continued until the end of treatment. MEPM and TAZ/PIPC are broad spectrum antimicrobials used as a single agent and must be utilized accordingly. For this reason, the antimicrobial stewardship team took the lead in adopting Metronidazole (MNZ) injection formulation in the hospital from August 2018. Prior to adoption, we provided doctors with information on how to handle MNZ preparations for intra-abdominal infection in combination with β-lactam antimicrobials such as cefepime (CFPM), ceftazidime (CAZ), and ceftriaxone (CTRX). As a result when comparing Days Of Therapy, the amount of MEPM and TAZ/PIPC decreased, the amount of MNZ, CFPM, and CAZ increased, and there was no significant difference in the amount of CTRX and all antimicrobial injections used. There was no difference in the number of Clostridioides difficile infection occurrences, and there was no significant difference in the effect on the susceptibility of Pseudomonas aeruginosa. It is suggested that the adoption of MNZ and provision of information in advance may contribute to the proper use of broad spectrum antimicrobials.