[Evaluation of human albumin use in a Brazilian hospital]

Human albumin is frequently used without regard for the relationship between its pharmacological properties and the respective disease. We investigated the prescription of human albumin in a Brazilian public hospital with emphasis on adherence to international guidelines. Data were gathered from pharmacy and medical records. From March to August 2001, 99 patients (>or= 15 years) received 1,475 units of human albumin, ordered in 498 prescriptions. The reason for prescribing human albumin was independently collected from medical records by two health professionals, and agreement was assessed by kappa statistics (95%CI: 0.72-0.85). According to different guidelines, prescriptions were classified as appropriate (33.1%), inappropriate (61.8%), controversial (4.6%), or undetermined (0.4%). Two probable cases of adverse reactions were identified. The proportion of inappropriate prescriptions is worrisome due to the product's high cost and its potential to cause adverse reactions. An appropriate strategy would be to encourage the application of guidelines issued by the national regulatory agency to promote rational use of human albumin and maximize patient safety.