Category: Professional Posters
Purpose: The objective of this medication use evaluation (MUE) is to retrospectively assess the appropriateness of use of ceftolozane/tazobactam (C/T) at a tertiary-care teaching hospital throughout the years 2017-2018.
Methods: A retrospective observational MUE was conducted at the American University of Beirut Medical Center, a 400-bed tertiary-care teaching hospital in Lebanon. The study included all patients who received at least one dose of C/T from August 1, 2017 through October 31, 2018. A pharmacy-generated list identified patients eligible for the study. Data were gathered from the patients’ medical records using a structured data collection form. The latter included patient demographic information, co-morbidities and past medical history, site(s) of infection(s) and corresponding culture results, indication(s) for the use, dosing information, laboratory results, concomitant medications received, drug-drug interactions, and documentation of ADEs.
Appropriateness of use of C/T was based on the indication for which it was prescribed, the relevance of its initiation as empiric therapy, and proper de-escalation to a narrower-spectrum antibiotic or switching after cultures results were out. If any of these criteria was not met, the use of C/T was considered inappropriate.
Appropriateness of dosing was based on the initial regimen used for the indication and patient’s renal function, as well as the daily regimen based on the patient’s changes in kidney function.
Descriptive statistics such as mean values, percentages, and standard deviations, when applicable, were used to summarize to data. Statistical data were generated using SPSS, version 24. Informed consent was waived due to the study design, which aims at quality improvement.
Results: A sample of 111 patients was included and analyzed. The main indication of C/T was nosocomial pneumonia for 71/111 (63.96%) of the patients. Other indications included cUTI (8.11%), cIAI (8.11%), skin and soft tissue infections (6.31%), bacteremia (0.9%), and unknown focus (12.6%). Following clinical appropriateness, C/T was found to be properly used in 85.59% of the time. As for dosing, appropriate regimens were used in 79.28% of the cases. All patients received C/T intravenously and at a frequency of “every eight hours”, both of which are 100% appropriate. Furthermore, the duration of use of C/T was suitable in 98.95% of the cases. Concerning the use of metronidazole, it was prescribed in 55.55% of the cases in which it was indicated (5/9 patients). Moreover, no adverse drug reactions were found with the use of C/T. Finally, regarding drug-drug interactions, two patients (1.8%) were on acenocoumarol, which can interact with C/T.
Conclusion: Overall, the study showed that C/T is appropriately prescribed and administered at the medical center. These results may be further optimized by increasing the education of healthcare professionals and using effective antimicrobial stewardship practices. Finally, it is crucial to highlight that pharmacists have a major potential to aid in antimicrobial decision-making and improving patient outcomes.