Antimicrobial consumption data from pharmacy and nursing records: how good are they?
OBJECTIVE
To determine whether randomly selected intravenous (IV) antimicrobial doses dispensed from an inpatient pharmacy were administered.


METHODS
This was a prospective, cross-sectional study in which dose administration was confirmed by direct observation and by assessment of the medication administration record (MAR). A retrospective analysis of the return rate of unused IV antimicrobial doses was performed subsequently.


METHODS
Medical and surgical intensive care units (ICUs) and non-ICUs of a 550-bed urban public teaching hospital.


METHODS
Hospitalized patients with an order in the pharmacy database for an IV antimicrobial during 9 non-consecutive weekdays in June 1999.


RESULTS
Of 397 doses, 221 (55.7%) assessed by bedside observation and 238 (59.9%) assessed by MAR review were classified as administered; 139 doses (35.0%) were dispensed but changes in the drug order or the patient's status prevented their administration. In the subsequent assessment, of 745 IV antimicrobial doses dispensed during 24 hours, 322 (43.2%) were returned to the pharmacy unused; 423 (56.8%) of the doses-consistent with our prior observations-were presumably administered.


CONCLUSIONS
Because computerized pharmacy data may overestimate actual antimicrobial consumption, such data should be validated when used in studies of hospital antimicrobial use. Dispense-return analysis offers a simple validation method.
Itokazu
Gail S
GS
John H. Stroger, Jr Hospital of Cook County, Division of Infectious Diseases, 637 S. Wood St., Durand Building - Room 110, Chicago, IL 60612, USA. gitokazu@uic.edu
Glowacki
Robert C
RC
Schwartz
David N
DN
Wisniewski
Mary F
MF
Rydman
Robert J
RJ
Weinstein
Robert A
RA
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D017723:Drug Utilization Review / Q000379:methods*; D006801:Humans; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D008499:Medical Records; D009737:Nursing Records; D010607:Pharmacy Service, Hospital / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents