The Pattern of In-patient Colistin Prescription for Patients Admitted to Imam Reza Hospital at Mashhad

Document Type : Research Paper

Authors

1 Associate Professor of Clinical Pharmacology, Department of Clinical Pharmacy, Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

2 PhD in Pharmacy, Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran

3 Professor of Clinical Pharmacology, Department of Clinical Pharmacy, Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Associate Professor of Infectious Diseases, Author in charge, Department of Infectious and Tropical Diseases, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Colistin is an old antibacterial agent, which is using for multiple drug resistant (MDR) infections. Due to increased rate of MDR infections, the use of this agent is rising worldwide. The aim of this study was to identify colistin utilization patterns in a teaching hospital.
Materials and Methods: This prospective study performed on 43 patients admitted to Imam Reza Hospital at Mashhad from March 2018 until February 2019 who received more than three doses of Colistin. At the beginning oof the study, demographic characteristics, Colistin doses, laboratory findings, culture results and the response to treatment bwere recorded. Finally, Data were analyzed by SPSS v.16 software and the frequency of errors in Colistin indication, dose, dose intervals, and dose adjustments were evaluated, also for drug interactions.
Findings: Out of 43 patients who received colistin, burning (39.53%) was the main indication for Colistin prescription. Colistin was prescribed based on microbiological findings for 20.93% of cases, only. Colistin was administered prior to culture response for 39.53% of cases, and for 39.53% of cases no specimen for culture was sent. In 81.25% of cases the received dose was correct and in 18.75% the dose was more than standard.Dose adjustment based on creatinine monitoring was not performed properly in 71.43% of cases. A total of 541 Colistin vials were administered without indication and a cost of 90.347.000 Rials was imposed on the Health system.
Conclusions: The results of this study indicate that there is a pressing need for physicians' training programs and appropriate strategies for prescribing Colistin in the treatment protocols.

Keywords

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medical journal of mashhad university of medical sciences
Volume 63, Issue 2
July and August 2020
Pages 2271-2291

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