Drug use evaluation of ciprofloxacin: impact of educational efforts on appropriateness of use.
OBJECTIVE
To evaluate the appropriateness of ciprofloxacin use in a 550-bed general hospital before and after an educational intervention.


METHODS
A drug use evaluation was carried out for 6 weeks, to examine the appropriateness of initiating therapy with ciprofloxacin, as judged by compliance with the hospital's protocols for antibiotic use. The results were distributed to all the hospital physicians, together with a review of the usage guidelines. Four months later the survey was repeated to examine the effects of this educational effort on the patterns of use.


RESULTS
During the initial survey, 115 patients were treated with ciprofloxacin. During the follow-up 126 patients were treated with ciprofloxacin. The percentage of unjustified use had decreased from 31% to 13% at follow-up (P<0.005). Improvement was seen in all the hospital departments needing improvement and most significantly in the medical departments. The most frequent indication for use of the drug was urinary tract infection (86 patients (36%) in total in the two stages). The most significant improvement was in justified usage for urinary tract infections: from 65% in the initial stage to 88% in the second stage (P < 0.025).


CONCLUSIONS
This study indicates that performing a drug use evaluation and distributing the results to the doctors concerned has a beneficial effect on the appropriateness of drug use and provides an important tool for identifying the main problems in prescribing, so that educational efforts can be focused.
Hammerman
A
A
Hadassah-Hebrew University School of Pharmac, Jerusalem, Israel.
Greenberg
A
A
Yinnon
A M
AM
D000900:Anti-Bacterial Agents / Q000191:economics / Q000592:standards / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000191:economics / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data; D017723:Drug Utilization Review; D004502:Education, Medical, Continuing; D006769:Hospitals, General; D006801:Humans; D010818:Practice Patterns, Physicians'; D014552:Urinary Tract Infections / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin