Drug utilization evaluation of third generation cephalosporins in a tertiary care hospital in South India

The purpose of the study was to evaluate the prescribing pattern of third generation cephalosporins in a tertiary care hospital and develop guidelines for its use. Antibiotic utilization evaluation of third generation cephalosporins was carried out over a period of eight months in medicine and pediatric wards by evaluation of patient case notes. A guideline for the use of third generation cephalosporins was prepared by the method of formal consensus and was implemented in the hospital. Appropriateness of use of third generation cephalosporins before and after implementation of guidelines was assessed in terms of indication for use, dose, frequency of administration, duration of therapy and change over from intravenous route to oral therapy with regard to the prepared guidelines. A total of 200 prescriptions containing third generation cephalosporins were reviewed and assessed for appropriateness, of which 100 each were before and after implementation of the guidelines. Ceftriaxone was the most commonly prescribed cephalosporin and enteric fever the most common indication for which is used in the pre and post implementation phase. The overall appropriateness of use of third generation cephalosporins before implementation of the guidelines was 91% for indication, 77% for dose,100% for frequency of administration, 81% for duration of therapy and 81% for change over from intravenous route to oral therapy. After implementation of guidelines, an improvement in appropriateness was seen for the various parameters such as indication (93%), dose (94%), duration of therapy (90%), change over from intravenous route to oral therapy (86%). This study shows that drug utilization evaluation programs and clinical practice guidelines does have the potential for making a positive contribution to health care by promoting effective use of drugs. © APTI.