An audit of third generation cephalosporin prescribing in a tertiary care hospital.
BACKGROUND
There is increasing resistance to commonly used antibiotics, including third generation cephalosporins, and an increasing cost burden.


OBJECTIVE
To assess the appropriateness of prescribing of third generation cephalosporin antibiotics in a tertiary teaching hospital.


METHODS
Prescriptions of third generation cephalosporins (ceftriaxone, cefotaxime and ceftazidime) to inpatients were identified prospectively by the Hospital Pharmacy Department for a six week period during May-June 1994. Clinical data and indications were obtained from patient records and, when necessary, by interviewing the prescriber and by patient assessment. Criteria for appropriate prescribing were according to nationally accepted criteria outlined in the 1994-95 Antibiotic Guidelines handbook. All inpatients who were prescribed a third generation cephalosporin at Flinders Medical Centre for the duration of the audit period were eligible. This included medical, surgical, paediatric, obstetric and gynaecology inpatients.


RESULTS
Sixty-five per cent of prescriptions for third generation cephalosporins were judged appropriate, 31% inappropriate and 4% doubtful. Inappropriate use was found particularly in the treatment of respiratory tract infections and abdominal sepsis, and in surgical prophylactic use.


CONCLUSIONS
Third generation cephalosporin prescribing in a tertiary care teaching hospital is frequently inappropriate, as judged against widely available Australian guidelines.
LeMire
M
M
Microbiology and Infectious Diseases, Flinders Medical Centre, Adelaide, SA.
Wing
L
L
Gordon
D L
DL
D000328:Adult; D019072:Antibiotic Prophylaxis; D002511:Cephalosporins / Q000627:therapeutic use*; D002648:Child; D017723:Drug Utilization Review; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008485:Medical Audit; D012141:Respiratory Tract Infections / Q000188:drug therapy; D013021:South Australia
D002511:Cephalosporins