title: The purpose and appropriateness of carbapenem use in a single university hospital, 2009-2013.
abstract: This is a retrospective review study to investigate changes in carbapenem consumption and to evaluate the proportion of inappropriate empirical use of carbapenem in the months of September and October of 2009, 2011, and 2013 in a single university-affiliated hospital. Total carbapenem use was classified into 3 categories: prophylactic, directed, and empirical. If an empirical prescription was continued without documentation of any eligible etiologic microorganism, we defined this as 'inappropriate' use. We also considered it 'inappropriate' when a patient's culture revealed no pathogen and the patient was initially not in severe sepsis or septic shock and did not have a history of admission to a health-care facility or of colonization with a pathogen eligible for carbapenem within 3 months. The total amount was 48.1, 51.1, and 91.0 defined daily doses/1000 patient-days in 2009, 2011, and 2013, respectively. Empirical use accounted for 78.4% of all prescriptions. The proportion of inappropriate empirical use ranged from 15.0 to 38.9% of the empirical carbapenem prescriptions.
authors.affiliation: a Department of Internal Medicine , Seoul National University College of Medicine , Seoul , Republic of Korea.
authors.forename: Doran
authors.initials: D
authors.lastname: Yoon
authors.affiliation: b Infection Control Service , Seoul National University Hospital , Seoul , Republic of Korea.
authors.forename: Hei Lim
authors.initials: HL
authors.lastname: Koo
authors.affiliation: a Department of Internal Medicine , Seoul National University College of Medicine , Seoul , Republic of Korea.|b Infection Control Service , Seoul National University Hospital , Seoul , Republic of Korea.
authors.forename: Pyeong Gyun
authors.initials: PG
authors.lastname: Choe
authors.affiliation: a Department of Internal Medicine , Seoul National University College of Medicine , Seoul , Republic of Korea.
authors.forename: Kyoung-Ho
authors.initials: KH
authors.lastname: Song
authors.affiliation: a Department of Internal Medicine , Seoul National University College of Medicine , Seoul , Republic of Korea.
authors.forename: Wan Beom
authors.initials: WB
authors.lastname: Park
authors.affiliation: a Department of Internal Medicine , Seoul National University College of Medicine , Seoul , Republic of Korea.
authors.forename: Ji Hwan
authors.initials: JH
authors.lastname: Bang
authors.affiliation: a Department of Internal Medicine , Seoul National University College of Medicine , Seoul , Republic of Korea.
authors.forename: Eu Suk
authors.initials: ES
authors.lastname: Kim
authors.affiliation: a Department of Internal Medicine , Seoul National University College of Medicine , Seoul , Republic of Korea.
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Park
authors.affiliation: a Department of Internal Medicine , Seoul National University College of Medicine , Seoul , Republic of Korea.
authors.forename: Hong Bin
authors.initials: HB
authors.lastname: Kim
authors.affiliation: a Department of Internal Medicine , Seoul National University College of Medicine , Seoul , Republic of Korea.
authors.forename: Myoung-Don
authors.initials: MD
authors.lastname: Oh
authors.affiliation: a Department of Internal Medicine , Seoul National University College of Medicine , Seoul , Republic of Korea.|b Infection Control Service , Seoul National University Hospital , Seoul , Republic of Korea.
authors.forename: Nam Joong
authors.initials: NJ
authors.lastname: Kim
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods; D015780:Carbapenems / Q000627:therapeutic use*; D006785:Hospitals, University; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy; D012772:Shock, Septic / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems
keywords: Carbapenem; antibiotic stewardship