Effects of Use Notification Policy for Carbapenem Antibacterial Drugs

Abstract

  Recent inappropriate use of carbapenem antibacterial drugs (CBPM) in Japan may lead to increased medication costs and more resistant strains of bacteria. To ensure the appropriate use of CBPM, notification of the Infection Control Committee after prescription of CBPM has become mandatory in our hospital since April 1 2006. We investigated the reasons for CBPM administration and corresponding information on the identification of pathogens between April 1, 2006 and January 31, 2007. The amounts and cost of the CBPM used and cultured pathogen patterns before and after the implementation of the use notification policy were compared. There were 388 cases of CBPM use in the study period. Pathogens were identified before CBPM administration in 66 cases, whereas CBPM were given as empiric therapy in 238 cases after specimens were collected. Pathogens were later identified in 146 of these 238 cases. On the other hand, 84 cases received CBPM therapy without prior specimen collection. After the use notification policy was implemented, use of CBPM decreased by 33% and cost by approximately 16 million yen. Among all antibacterial drugs, CBPM use decreased by 7% and cephems use increased by 6%. No significant changes were found in the pathogens identified in the sputum, urine and blood samples collected. CBPM use notification policy is likely to decrease both the amounts and costs of antibacterial drugs used.