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Updated: Aug 25, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Pediatric drug utilization evaluation of cefepime and piperacillin/tazobactam

Priengrutai Prasopchoknapaporn1, Sophida Boonsathorn1, Chonnamet Techasaensiri1

  • 1Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Pediatrics International : Official Journal of the Japan Pediatric Society
|October 18, 2022
PubMed

Insights

Drug utilization evaluation (DUE) improved antibiotic appropriateness in pediatric patients. This systematic review highlights DUE

Area of Science:

  • Pediatric Pharmacology
  • Antimicrobial Stewardship
  • Health Services Research

Background:

  • Drug utilization evaluation (DUE) systematically assesses medication use to optimize antibiotic prescribing.
  • This study focused on cefepime and piperacillin/tazobactam in a pediatric tertiary care setting.

Purpose of the Study:

  • To evaluate the effectiveness of DUE in improving the appropriateness of cefepime and piperacillin/tazobactam prescriptions for pediatric patients.
  • To identify factors associated with inappropriate antibiotic use.

Main Methods:

  • A quasi-experimental study conducted at Ramathibodi Hospital from March 2020 to August 2021.
  • Inclusion criteria: hospitalized children (1 month to 20 years) receiving cefepime or piperacillin/tazobactam.
  • Retrospective evaluation of prescriptions pre-DUE implementation and voluntary DUE use during the study period.

Main Results:

  • The DUE group showed significantly higher appropriateness of empirical antibiotic prescriptions (93.5% vs. 83.5%, P=0.003).
  • DUE was significantly associated with appropriate empirical prescribing (adjusted OR 5.32).
  • Inappropriate prescribing was linked to critical care wards and urinary tract infections (UTIs).

Conclusions:

  • Drug utilization evaluation can enhance the appropriate empirical use of cefepime and piperacillin/tazobactam in pediatric populations.
  • Critical care settings and UTIs were associated with suboptimal empirical antibiotic treatment.
Abstract

Keywords:
antibiotic stewardshipcefepimedrug utilization evaluationpiperacillin/tazobactam

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