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Abstract

Vol.66 No.4 July 2018

Effect of the early switch recommendation from sulbactam/ampicillin injection to amoxicillin 500 mg/clavulanic oral through the use of a checklist

Yasuhiro Kamijo1), Akiyosi Shinohara2), Takaya Ito1), Waka Nakano1) and Shigeaki Hoshina1)

1)Pharmaceutical Center, Aizawa Hospital, 2-5-1 Honjo, Matsumoto, Nagano, Japan
2)Pharmaceutical Department, Aizawa East Hospital

Abstract

Switching to oral antibiotics was examined for the appropriate use of sulbactam/ampicillin.We thought that switching to an oral antimicrobial agent would proceed by clarifying the state of the patient and the recommended oral antimicrobial agent as a guide for switching from an antibiotic for injection to an oral antimicrobial agent. From June 13, 2016, the antibiotic adopted in the hospital was changed from sultamicillin tablets to amoxicillin / clavulanic acid tablets. A checklist was prepared as a guide to switch from sulbactam / ampicillin to amoxicillin 500 mg/clavulanic acid 125 mg× 3 times / day. On August 2, 2016, the clinical department conference in which each manager of department participated explained the contents of the checklist. If each doctor checked the checklist on sulbactam / ampicillin on day3, it was recommended to switch to amoxicillin 500 mg/clavulanic acid 125 mg× 3 times / day. We examined the status before and after switching to oral antibiotics (amoxicillin 500 mg/clavulanic acid 125 mg). The switching rate of oral antibiotics (amoxicillin 500 mg / clavulanic acid 125 mg) was 1.0% in the control group, and 22.1% in the intervention group (p< 0.01): the switching rate in the early oral antibiotic (amoxicillin 500 mg / clavulanic acid 125 mg) was 0% in the control group and 13.5% in the intervention group (p< 0.01). Breakdown of the switching rate to amoxicillin 500 mg/clavulanic acid 125 mg / times was 6.3% in the control group and 65.7% in the intervention group. Breakdown of the early switching rate to amoxicillin 500 mg/clavulanic acid 125 mg / times was 0% in the control group, and 82.4% in the intervention group. It appeared possible that switching to an oral antimicrobial agent could proceed by clarifying the state of the patient and the recommended oral antimicrobial agent as a guide for switching from an antibiotic for injection to an oral antimicrobial agent.

Key word

oral antibacterial agent, antimicrobial stewardship program, pneumonia

Received

May 22, 2017

Accepted

April 23, 2018

Jpn. J. Chemother. 66 (4): 513-520, 2018