[Imipenem-cilastatin use in a university hospital in Chile]

Area of Science:

• Infectious Diseases
• Clinical Pharmacy
• Antimicrobial Stewardship

Background:

• Imipenem, a broad-spectrum antimicrobial, is costly and reserved for multi-resistant nosocomial infections.
• University hospitals often implement restriction policies for imipenem use, requiring supervisory evaluation.
• Appropriate use criteria are essential for managing expensive, broad-spectrum antibiotics like imipenem.

Purpose of the Study:

• To audit the effectiveness of a restriction policy for imipenem use.
• To evaluate the appropriateness of imipenem prescriptions based on pre-defined criteria.
• To quantify the impact of supervisory evaluation on imipenem utilization and cost savings.

Main Methods:

• An audit of imipenem supervisions was conducted over two periods in 2004.
• A total of 136 imipenem treatments were analyzed.
• Treatments were classified as appropriate, inappropriate, or discontinued prior to evaluation.

Main Results:

• 58.1% of imipenem treatments were deemed appropriate, while 11.8% were inappropriate.
• Physicians discontinued 20.6% of treatments before evaluation.
• Susceptibility to other antimicrobials was the primary reason for inappropriate imipenem use.

Conclusions:

• The restriction policy effectively managed imipenem use, with a majority of treatments being appropriate.
• Physician discontinuation of treatments prior to evaluation led to significant cost savings.
• Antimicrobial stewardship programs are crucial for optimizing the use of expensive antibiotics.