Abstract

Objective: To evaluate the quality of antimicrobial drug use in a university hospital medical department (Department of Medicine, University Hospital Rijeka, Croatia) with 279 hospital-beds in wards containing patients from endocrinology, gastroenterology, hematology, clinical immunology, cardiology and coronary care unit, nephrology and pulmonology sections of the hospital. Methods: The appropriateness of antimicrobial treatment for all in-patients in the Department of Medicine was assessed in a prospective, longitudinal survey carried out during a 21-week period using Kunin’s criteria where Categories I and II indicate “appropriate therapy”, Categories III and IV indicate major deficiency in the choice or use of antimicrobials. Category V indicates unjustified antimicrobial administration. Results: During the study period, a total of 438 patients were treated with antimicrobials in the Department of Medicine. Of these, 159 (36%) received antimicrobials appropriately (Category I and II), 180 (41%) needed antimicrobials (Category III and IV) but they should have been prescribed differently. The main reason for inappropriate antimicrobial treatment was the wrong choice of antimicrobials (broad-spectrum where a narrow spectrum antibiotic would have been sufficient). In the case of 99 patients (23%) an indication for antimicrobial therapy did not exist (Category V). Conclusion: The main reason for suboptimal use of antimicrobials was the over-prescribing of broad-spectrum antimicrobials. This situation should be corrected e.g. by changes in the post-graduate medical teaching program.

Author Details

Authors

• V. Vlahovic-Palcevski
• I. Francetic
• G. Palcevski
• S. Novak
• M. Abram
• U. Bergman

Departments

• ¹ Department for Clinical Pharmacology, University Hospital Center Rijeka, University of Rijeka Medical School, Rijeka, Croatia,
• ² Unit for Clinical Pharmacology, Department of Medicine, University Hospital Center Rebro, University of Zagreb Medical School, Zagreb, Croatia,
• ³ Pediatric Clinic, University Hospital Center Rijeka, Rijeka, Croatia,
• ⁴ Department of Medicine, and
• ⁵ Department for Clinical Microbiology, University Hospital Center Rijeka, University of Rijeka Medical School, Rijeka, Croatia,
• ⁶ Division of Clinical Pharmacology, Department of Laboratory Medicine, WHO Collaboration Center for Drug Utilization Research and Clinical Pharmacological Services, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden

Address

V. Vlahovic-Palcevski, MD, PhD; Department of Clinical Pharmacology, University Hospital Center Rijeka, Kresimirova 42, 51000 Rijeka, Croatia
Email: [email protected]

Citation