Drug Utilization Evaluation of Imipenem in an Educational Hospital in Mazandaran Province

Background: imipenem, a member of the carbapenem class of beta-lactam antibiotics,is a broadly active antimicrobial. due to indiscriminate use, drug resistance has spreadin many hospitals. the aim of this study was to evaluate utilization of imipenem inimam khomeini educational hospital in sari. methods: over a three-month periodfrom september to november 2010, all patients who received imipenem duringhospitalization were included. demographic data, duration of imipenem therapy, dose,dosage adjustment in renal insufficiency and co-prescribed antimicrobials wereextracted from patients' medical files. recommendations of uptodate 20.2 andsanford 2009 were considered as standards of rational imipenem prescribing. dataanalysis was performed by spss 17 software. results: a total of 100 patients with amean age of 51.4±21.4 were enrolled in the study. dose and duration of imipenemtherapy were appropriate in 64 (64%) and 50 (50%) patients, respectively. in 83 (83%)cases, empiric antibiotic therapy was initiated within the first day of admission whichincluded imipenem in 31 patients (37%). all patients received imipenem as empirictherapy. the most common co-prescribed antimicrobial agent with imipenem wasvancomycin (66 cases). imipenem was administered by consult of an infectiousspecialist just in 30% of patients. 14 imipenem prescriptions (14%) required dosageadjustment according to the patient's renal function, whereas it was performed only for5 (35%) patients. culture tests were carried out for 29 (29%) cases. conclusion: highrate of empiric prescription of imipenem without considering culture and antimicrobialsusceptibility results, lack of attention to dosage adjustment in renal insufficiency andinitiation of antimicrobial therapy at the time of admission were the most importantaspects of irrational use of imipenem that observed in this study. providing a reliableculture/sensitivity setup and prescribing of imipenem based on a specific guideline arerecommended.