title: Evaluation of ceftriaxone utilization at multicenter study.
abstract: OBJECTIVE
  As bacterial resistance to antimicrobial agents has grown due to the increasing use of antimicrobial agents, we sought to evaluate the suitability of ceftriaxone usage (representative of third generation cephalosporins) at 10 university hospitals in Korea.
  
  
  METHODS
  We prospectively evaluated the appropriateness of antibiotic usage in 400 adult patients who received ceftriaxone between February 1, 2006 and June 30, 2006. Drug utilization evaluation (DUE) methods were based on standards set forth by the American Society of Hospital Pharmacists. The DUE criteria used in this study were modified to be more suitable in our hospital setting: justification of drug use, critical and process indications, complications, and outcome measures.
  
  
  RESULTS
  The average patient age was 64.4 years. The utilization of ceftriaxone was appropriate in 262 cases (65.5%) for the justification of use, while inappropriate use was observed in 138 cases (34.5%). Common reasons for inappropriate use of ceftriaxone included continued empiric use for presumed infections, prophylactic perioperative injection, and empiric therapy for fever. Most of the critical indications showed a high rate of suitability (66.5-98.5%). Complications occurred in 37 cases (9.3%). With respect to outcome measures, clinical responses were observed in 60.7% of cases, while only 15.7% of cases showed evidence of infection eradication via negative cultures.
  
  
  CONCLUSIONS
  Appropriate use (65.5%) of ceftriaxone was higher than inappropriate use (34.5%) at university hospitals in Korea. Inappropriate utilization, however, including continued empiric use for presumed infections and prophylactic perioperative injection remained high. Intensification of educational programs and antibiotic control systems for ceftriaxone is needed to improve the suitability of antimicrobial use.
authors: Department of Internal Medicine, Dong-A University Hospital, Busan, Korea.
authors: Hyuck
authors: H
authors: Lee
authors: Dongsik
authors: D
authors: Jung
authors: Joon Sup
authors: JS
authors: Yeom
authors: Jun Seong
authors: JS
authors: Son
authors: Sook-In
authors: SI
authors: Jung
authors: Yeon-Sook
authors: YS
authors: Kim
authors: Chun Kwan
authors: CK
authors: Kim
authors: Hyun-Ha
authors: HH
authors: Chang
authors: Shin-Woo
authors: SW
authors: Kim
authors: Hyun Kyun
authors: HK
authors: Ki
authors: Chi Sook
authors: CS
authors: Moon
authors: Doo Ryeon
authors: DR
authors: Chung
authors: Kyong Ran
authors: KR
authors: Peck
authors: Jae-Hoon
authors: JH
authors: Song
authors: Gun-Jo
authors: GJ
authors: Woo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone