Antibiotic utilization pattern in a general medical ward of a tertiary medical center in Saudi Arabia

Abstract

To assess the pattern of antibiotic utilization and outcome of patients with bacteremia in a General Medical Ward, all positive blood cultures (BC) over a 12-month period from January 1994 to December 1995 were retrospectively reviewed. Fifty-two positive BC were recorded in 43 patients (63% males, 37% females; mean age 65.9 ± 16.6). 72% of the patients received antibiotics before or soon after obtaining the BC, and ceftriaxone was the most frequently-prescribed antibiotic (41.93%), either alone or in combination with other antibiotics. The bacteremia was due to gram-positive cocci in 60.46% of cases, gram-negative rods in 30.23%, and gram-positive rods in 9.30%. Positive BC due to contamination were not included. The most common gram-positive cocci were Staphylococcus epidermidis, followed by S. aureus, while the most common gram-negative bacilli were Brucella species, Proteus mirabilis, and Klebsiella sp. The suspected sources of the bacteremia were respiratory (21.2%), urinary (19.2%), or skin (19.2%). A subsequent change in the antibiotics regimen was done in 69.76% cases after BC results became available with no apparent effect on the outcome. Adding vancomycin and clindamycin was the most frequent change done (19.4% for each equally). Complications developed in 69.76% of patients, with 88.66% of them suffering from sepsis/shock. 69.23% of the patients improved and 30.77% expired; death was related to infection in 87.5% of cases. In conclusion, most bacteremia in the medical ward of the hospital were due to gram-positive cocci, which should be considered in antibiotic selection prior to BC. Risk factors for acquiring Brucellosis should always be obtained.

Impact of Culture Sensitivity Reports on the Pattern of Antibiotics use and Cost of Therapy: A Prospective Observational study

“…A high proportion of patients in our study received antibiotics before the availability of culture results, similar to other studies [53]. However, different to a recent study in South Africa where 83% of antibiotics were modi ed following sensitivity reports [54].…”

Prescription pattern of antimicrobial agents in a teaching hospital of South India

“…In our study most preferred antimicrobial was cefixime although ampicillin, metronidazole and ciprofloxacin were also used in substantial number of cases. In the study of Al Shimememri et al 12 ceftriaxone was the most commonly prescribed antimicrobial agent. While Giri et al 13 observed that ampicillin with cloxacillin combination was the most favored antimicrobial agents followed by metronidazole, ampicillin alone, gentamicin and cefuroxime.…”

“…Factors for inappropriate prescribing of drugs include wrong choice of drug with doubtful efficacy/safety for the specific indication, drug misinformation, industry influenced marketing practices, lack of recognition of drug resistant strains, shortage of supplies of appropriate drugs, heavy workload, lack of laboratory facilities for cultures chiefly due to funding. 4,5 Al Shimemeri et al 12 in their study which was conducted in a general medical ward of a tertiary medical center in Saudi Arabia observed that a high proportion of patients received antimicrobial agents prior to the availability of the results of blood culture tests.…”

Prescription pattern in the department of surgery in a tribal district hospital of Andhra Pradesh, India

“…Al Shimememri et al . [17] in their study observed ceftrixone as the most common drug without use of culture and sensitivity tests. Thomas et al .…”