Drug use evaluation of antibiotics in a pediatric teaching hospital.
OBJECTIVE
To determine the incidence and type of antibiotic use variances at our institution.


METHODS
Inpatient bacterial culture and susceptibility results were reviewed for 1 week per month. Medication administration records were evaluated to determine whether antibiotic selection was appropriate, given the susceptibility of the organism. Process indicators included use of the least costly antibiotic, as well as appropriate dose, interval, and route of administration. The complete medical record was reviewed for all patients if management did not appear to meet criteria.


METHODS
A 225-bed, tertiary-care children's teaching hospital.


RESULTS
Thirty-five (8.2%) of 428 patients reviewed over 12 months had a total of 49 variances: failure to treat (3), treatment of contaminant/colonizer (2), use of more costly agent (10), failure to revise therapy (8), inappropriate route (2), inappropriate empiric antibiotic (4), incorrect dose (3), unnecessary multiple antibiotics (6), inappropriate drug (8), and prolonged prophylaxis (3).


CONCLUSIONS
Thirty-five patients with 10 types of variances were identified during the study. Follow-up monitoring will assess the impact of educational efforts on the incidence of variances. Specific problem antibiotics have been identified for further audits.
Lee
K R
KR
Le Bonheur Children's Medical Center, Memphis, TN 38103.
Leggiadro
R J
RJ
Burch
K J
KJ
D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004333:Drug Administration Routes; D004334:Drug Administration Schedule; D017723:Drug Utilization Review / Q000706:statistics & numerical data*; D006744:Hospital Bed Capacity, 100 to 299; D006776:Hospitals, Pediatric / Q000592:standards*; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D008499:Medical Records; D008826:Microbial Sensitivity Tests; D013714:Tennessee
D000900:Anti-Bacterial Agents