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A concurrent cefuroxime use evaluation in pediatric patients
F C Obilio1, C Petrou, M H O'Brodovich
1Toronto East General Hospital, Ontario.
Insights
This study evaluated cefuroxime use in pediatric patients, finding 77% met criteria. Pharmacist interventions improved therapy in some cases, highlighting the value of drug use evaluation programs.
Area of Science:
- Pediatric Pharmacology
- Antimicrobial Stewardship
- Drug Utilization Research
Background:
- Cefuroxime is a commonly prescribed antibiotic in pediatric care.
- Ensuring appropriate antibiotic use is crucial for patient outcomes and preventing resistance.
- Drug Use Evaluation (DUE) programs are essential for monitoring and optimizing medication therapy.
Purpose of the Study:
- To concurrently evaluate the utilization of cefuroxime in pediatric patients.
- To assess adherence to pre-established criteria for cefuroxime prescribing.
- To determine the impact of pharmacist interventions on cefuroxime therapy.
Main Methods:
- Concurrent data collection of clinical information for pediatric patients receiving cefuroxime.
- Assessment of cefuroxime therapy against defined criteria by a pediatric liaison pharmacist.
- Intervention by the pharmacist for non-compliant therapy, followed by review by a DUE Coordinator and pediatrician.
Main Results:
- Thirty-five pediatric patients received cefuroxime during the evaluation period, all empirically.
- Community-acquired pneumonia was the most common indication (21 courses), with 18 meeting criteria.
- Overall, 77% of cefuroxime courses met established criteria; pharmacist interventions led to therapy changes in 3 of 6 instances.
Conclusions:
- Seventy-seven percent of empirical cefuroxime use in pediatric patients met established criteria.
- Pharmacist-led drug use evaluation can identify suboptimal prescribing.
- Interventions by clinical pharmacists can lead to positive adjustments in pediatric antibiotic therapy.
Abstract:
A concurrent evaluation of cefuroxime use in pediatric patients is described. From March 5, 1991 to May 15, 1991, the use of cefuroxime in pediatric patients was evaluated. The pediatric liaison pharmacist collected clinical information about each patient prescribed cefuroxime and assessed the therapy according to pre-established criteria for use. When therapy did not meet criteria, the pharmacist could intervene by speaking with the prescribing physician. The Coordinator, Drug Use Evaluation (D.U.E.) Program and a pediatrician, reviewed the data collection forms to assess whether therapy met criteria and the outcome of pharmacist-physician interactions. Thirty-five pediatric patients were prescribed cefuroxime during the concurrent evaluation. All courses were empiric. Community-acquired pneumonia accounted for 21 treatment courses in which cefuroxime was prescribed with 18 of these deemed to meet the criteria. It was also prescribed empirically in otitis media (eight cases), meningitis (two cases). Overall, seventy-seven percent of therapeutic courses of cefuroxime were found to meet established criteria for use. The pediatric clinical pharmacist intervened in six therapeutic courses which did not meet criteria. Three of these interventions resulted in a change of therapy for the patient.