Evaluation of the use of piperacillin/tazobactam (Tazocin®) at Hamad General Hospital, Qatar: are there unjustified prescriptions?

Abstract

ObjectivesThe aim of this study was to evaluate the appropriateness of piperacillin/tazobactam (Tazocin®; Pfizer, New York, NY) usage in our hospital.Subjects and methodsThis retrospective study was designed to involve all patients admitted to Hamad General Hospital and prescribed piperacillin/tazobactam as an empiric therapy from January 1 to March 31, 2008. The medical records of such patients were retrospectively reviewed and studied.ResultsDuring this period, 610 prescriptions were ordered for 596 patients. The main indication for initiation of Tazocin was sepsis (207/610; 34%). The overall rate of appropriateness of empirical therapy was 348/610 (57%). Most of the inappropriate prescriptions were in cases of aspiration pneumonia and abdominal infections, with inappropriate prescriptions found mostly in surgical wards (86%) and the surgical intensive care unit (66.7%). Septic work-up results showed positive cultures in 57% (345/610) of cases. There were 198/254 prescriptions (78%) where antibiotics were changed according to the sensitivity data to narrow-spectrum antimicrobials. In 56/254 (22%) cases, pathogens were susceptible to narrow-spectrum antibiotics even though piperacillin/tazobactam was continued.ConclusionOur study showed that there was an injudicious use of piperacillin/tazobactam at our hospital, evidenced by the significant number of inappropriate empiric prescriptions and inappropriate drug modifications, based on the results of microbial cultures and antibiograms.

the impact of antimicrobial stewardship strategies on antibiotic appropriateness and prescribing behaviours in selected countries in the Middle East: a systematic review

“…All studies provided recommendations for successful programme development and/ or implementation. Table 1 summarizes the studies in regard to the adoption by institutions of interventional strategies in order to assess and enhance antimicrobial use and prescribing behaviours by physicians (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32).…”

“…Eleven (61.1%) of these reported unwarranted and inappropriate use (typically overuse) of antimicrobials. The majority of the studies concluded that prescribing habits were to blame for the discrepancies observed, and that physicians were not prescribing according to local policies and guidelines (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). Conversely, 6 (33.3%) studies reported adherence to guidelines and local institutional policies (27)(28)(29)(30)(31)(32).…”

“…Some of these studies also reported that antimicrobial stewardship initiatives (restrictive measures, antimicrobial cycling, antimicrobial switch, etc.) likely influenced adherence rates (15,24,32).…”

“…All the studies we examined provided recommendations that are considered to be crucial for further enhancement of antimicrobial usage through implementation of successful antimicrobial stewardship programmes. Eight studies mentioned the importance of implementing local guidelines and policies (13,16,18,21,24,(25)(26)(27). It was also suggested that these should be supported…”

“…Other studies recommended that these policies should be updated regularly and must be readily available and disseminated throughout the institution (17,20,23,24,26). Other approaches were also mentioned.…”