We examined antibiotic use on an individual patient basis and investigated outstanding cases in detail to produce a guide for the activity of the Infection Control Committee of Kouseiren Chu-nou Hospital.
The prescription data for 14 frequently used antibiotic injections were collected by utilizing a computer database of hospital inpatients between March 1st and June 30th, 2001. Although the overall antibiotic usage seemed appropriate, some inappropriate usages were uncovered by investigations on an individual-patient basis, including a prolonged administration.
Vancomycin (VCM) was prescribed to some methicillin-resistant Staphylococcus aureus-negative patients. VCM was prescribed more than 14 days consecutively to 34. 4 % patients. All of these were considered to be inappropriate in regard to the usage specified for insurance. Therapeutic drug monitoring (TDM) was not carried out in all the patients administered VCM. Cefazopran was prescribed to many patients with respiratory infections. In addition, cefazopran was used as a first line medicine for empiric therapy in the treatment of pneumonia of the aged with chronic respiratory diseases.
In conclusion, we found antibiotic usage problems in our hospital. According to the results in this study, we made new guidelines for pharmacists to monitor antibiotic usage by inpatients. We also suggest that the coordination of infection control nurses with pharmacists remains an important next step in improving the appropriate use of antibiotics in our hospital.
