Drug use evaluation of cefepime at Khartoum North Teaching Hospital in Sudan

Abstract

Background Cefepime is essentially used for life‐threatening infections. Although overutilisation of antibiotics is strongly discouraged around the world, they are still overused in developing countries including Sudan. Objectives This study aims to evaluate the rational use of cefepime at Khartoum North Teaching Hospital‐Sudan. Methods A retrospective cross‐sectional, hospital‐based study was conducted in the internal medicine ward at Khartoum North Teaching Hospital from August/2018 to April/2019. The study covered medical records of adult patients receiving cefepime during the study period. Patient's data were analysed using simple descriptive statistics (frequency and percentage) and inferential statistics (logistic regression) to describe the relationship between dependent and independent variables. P ≤ .05 was considered statistically significant. Results Out of 90 patients, only 16.7% of patients were tested for antibiotic sensitivity. Cefepime was prescribed to 50% and 23.3% of patients for the treatment of UTIs/post‐dialysis and sepsis, respectively. Although the majority of patients (72.2%) received cefepime with appropriate indication, only 21.1% and 15.6% received the drug with appropriate dose and duration, respectively. Cefepime had been prescribed appropriately in a correct dose, duration, and indications for only 7.8% of patients. The vast majority of patients tested for kidney functions had elevated creatinine levels (96.1%); however, cefepime dose had been adjusted for only 4.1% of them. Conclusion This study highlighted the irrational use of cefepime regarding inappropriate dose, duration, and inadequate antibiotic sensitivity tests. A lack of attention to dosage adjustment in patients with renal impairment had been observed. Positive clinical outcome was significantly associated with antibiotic sensitivity test.

Prevalence of inappropriate drug dose adjustment and associated factors among inpatients with renal impairment in Africa: A systematic review and meta-analysis

“…Additionally, one study used a clinical outcome as a dependent variable and IDDA as an independent variable. 33 As a result, the regression model in the study revealed a significant association between high sCr and inappropriate drug usage.…”

“… 28 , 29 , 31 , 32 While the remaining three are barely referred to as adults in general. 27 , 30 , 33 One study included only chronic kidney disease (CKD) patients, 38 while the others included patients with acute kideny injury (AKI) or CKDs. The participants in those studies ranged in age from 42 to 54.6 years.…”

“… 33 The total number of prescriptions analyzed varies between 90 and 1581. 32 , 33 On the other hand, the number of prescriptions containing at least one drug requiring dose adjustment ranges from 815 to 74. 32 , 33 Moreover, the prevalence of IDDA ranged from 34% to 95%.…”

“… 32 , 33 On the other hand, the number of prescriptions containing at least one drug requiring dose adjustment ranges from 815 to 74. 32 , 33 Moreover, the prevalence of IDDA ranged from 34% to 95%. 30 , 33 Two studies reported inappropriate dosage and contraindications separately.…”

“… 32 , 33 Moreover, the prevalence of IDDA ranged from 34% to 95%. 30 , 33 Two studies reported inappropriate dosage and contraindications separately. 29 , 30 In these studies, dosing errors were more prevalent than in prescribing contraindicated medicine.…”