PSY25 - Utilization of Antimicrobial Agents at the Haematology Ward in a Public Hospital

Abstract

Antimicrobials are among the most utilized drugs on haematological patients in most hospitals. To determine its appropriateness, a drug utilization review was conducted to provide an insight on the pattern of use, determinants of use, quality of use and outcome of use in a public hospital. This is a descriptive study where 200 patient’s data were randomly extracted from the electronic hospital information system based on the defined inclusion criteria. Details of patient signs and symptoms and microbiological culture/sensitivity testing were retrieved by using Medication History Assessment, Pharmacotherapy Review Form, and Bed Head Ticket (BHT). Outcome is measured by examining the concordance to guidelines and DDD where the pattern and factors that influence its use. 152 patient data were evaluated. Their mean age was 46.0 (SD 16.9) years. The most antimicrobial prescribed were antibacterial (n=40) types, antifungal (n=8) and antiviral (n=2). Reason for the low number of cases for antifungal and antiviral agent was because it was been used as an adjunct therapy for fever neutropenic sepsis, stem cell transplants procedure and fungal and viral infection. Generally, the antimicrobial prescribed adhered to the current guideline. Most patients received antimicrobials for <7 days. No significant difference was observed of antimicrobial prescribing in terms of age, gender, race, and diagnosis. DDD for the most prescribed antibacterial:222 (Inj. cefepime), 96.3 (Inj meropenem) and 51.4 (Inj. piperacillin/tazobactam injection). The highest DDD for antifungal and antiviral agents: fluconazole capsule (53.79), acyclovir tablet (8.74) respectively. VEN analysis found the highest use for antibacterial, antifungal and antiviral were injection linezolid, injection caspofungin and acyclovir tablet respectively. Significant association were observed between diagnosis and prescriber category and CNS of antibacterial versus combination antibacterial (p<0.05). This study showed that the choice and dosing of prophylaxis antimicrobial agents in haematological patients is in accordance with their appropriate indications and standard therapy guideline.