Drug utilization evaluation of meropenem: an important broad-spectrum antibiotic for the treatment of serious bacterial infections in hospitalized patients

Increasing trend in the development of antibiotic resistance is one the major concerns of health care systems throughout the world. Several factors are responsible of the emergence of this problem of which frequent inappropriate uses of antimicrobial agents plays an important role. Therefore, in this study we aimed to assess the appropriateness of the usage of meropenem, a broad-spectrum antibiotic, in a teaching affiliated hospital. This study is an observational prospective research on drug utilization. All patients admitted to Masih Daneshvari hospital that had received meropenem during June to July 2011 were enrolled in the study. To evaluate the appropriate use of meropenem, an institutional standard guideline was designed by pharmacy and therapeutic committee using evidence-based guidelines. Prescriptions were considered appropriate if they were compliant with the guideline. The total number of meropenem vials used during this period was 2153 vials. Most prescriptions started empirically (85.9%). Of these, 16.9% of prescriptions continued according to lab results whereas 69% of meropenem courses remained empirical. Our results showed that meropenem was started appropriately in 64.8% of patients whereas just 74.3% of patients received the drug for an adequate duration. In conclusion, our study and several other surveys detected various areas of inappropriate use of broad-spectrum antibiotics such as meropenem. With regard to the important role of these drugs in the treatment of serious nosocomial infections, a combination of both restrictive and educational measures appears to be necessary to improve rational antibiotic usage as well as to decrease in the frequency of antibiotic resistant.