Vol.54 No.6 November 2006
Effort to promote proper use of anti methicillin-resistant Staphylococcus aureus agents and carbapenems
1)Department of Pharmacy, Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka, Japan
2)Department of General Medicine, Iizuka Hospital
3)Department of Pharmacy, Fukuoka University Chikushi Hospital
Abstract
Antibiotics abuse causes drug resistance. Between 2001 and 2004, we conducted several trials to evaluate the effectiveness of measures to inhibit antibiotic use. From September 2001, we required physicians treating patients with anti-MRSA agents, and from November 2003, those treating patients with carbapenems, to report the reason for their choice of antibiotics to an Infection Control Committee prior to administration to patients (reason-report). From October 2003, physicians with patients suffering from bacteremia were supported by infection control physicians (Guidance by ICD). In addition to the interventions above, from April 2004, through therapeutic drug monitoring (TDM), physicians prescribing drugs for all patients with MRSA received advice from pharmacists on optimal dosage. We studied the effects of these interventions on the prescription of carbapenems and anti-MRSA agents.
Combined, TDM and the other two interventions significantly reduced daily doses of vancomycin. Guidance by ICD decreased the number of patient prescribed anti-MRSA agents. Taking reason-report and guidance by ICD together raised the daily dose of panipenem/betamipron (0.5 g/V) significantly.
In conclusion, we found that presentation of a report detailing reasons for prescription is ineffective in limiting the amount of anti-MRSA agents prescribed, but both TDM and guidance by an infection control physician effectively reduced prescribed amounts. We consider that administration criteria of carbapenems are necessary.
Key word
anti MRSA agent, carbapenem, therapeutic drug monitoring (TDM)
Received
June 19, 2006
Accepted
August 23, 2006
Jpn. J. Chemother. 54 (6): 511-519, 2006
