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Are local clinical guidelines useful in promoting rational use of antibiotic prophylaxis in Caesarean delivery?

Authorized Users Only
2010
Authors
Ristić, Svetlana
Miljković, Branislava
Vezmar, Sandra
Stanojević, Dušan
Article (Published version)
Metadata
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Abstract
Objectives To identify changes in prescribing patterns of antibiotic prophylaxis in Caesarean delivery after introduction of local clinical guidelines. To identify changes in outcomes of prescribing antibiotics following the implementation of local clinical guidelines on antibiotic prophylaxis. Setting University of Belgrade, Medical School, Clinic of Gynaecology and Obstetrics "Narodni front" Belgrade, Serbia. Method A quantitative retrospective analysis of antibiotic use before (January-June 2005), and following (January-June 2006) implementation of guidelines on antibiotic prophylaxis in two wards. Patients who underwent Caesarean section prior to (261) and following (281) introduction of local guidelines, participated in this study. Main outcome measures Drug utilization cost presented as the number of DDD/100 bed days/eur, the average duration of hospital stay, number of wound infections. Results There was a significant change in prescribing patterns of antibiotic prophylaxis in C...aesarean section following introduction of local guidelines. The use of ceftriaxone, amikacin and metronidazole decreased (57.47% vs. 11.74%; 9.19% vs. 4.27%; 61.69% vs. 46.26%, respectively). On the other hand, the use of "older" antibiotics such as gentamicin, cefuroxime, cefazolin and ampicillin increased (14.56% vs. 29.18%; 9.2% vs. 17.44%; 9.58% vs. 45.2% and 0% vs. 3.9%, respectively). DDD/100 bed days/eur analysis revealed a 47% decrease of total cost for prophylactic antibiotic treatment in Caesarean section following local guideline implementation. In contrast, rate of wound infections and duration of hospital stay were not significantly different in both groups. Conclusion In an attempt to ensure cost-effective prophylactic use of antibiotics in Caesarean delivery, local clinical guidelines were introduced. They resulted in changes in prescribing patterns of antibiotics. There was a significant decrease in use of 'third' generation of cephalosporin's whereas the use of "older" antibiotics with proven efficacy and safety increased. In contrast, there was no significant change in treatment outcomes such as wound infection and average hospital stay.

Keywords:
Antibiotic prophylaxis / Caesarean delivery / Formulary / Local clinical guidelines / Serbia
Source:
Pharmacy World & Science, 2010, 32, 2, 139-145
Publisher:
  • Springer, Dordrecht
Projects:
  • Eksperimentalna i kliničko-farmakološka istraživanja mehanizma dejstva i interakcija lekova u nervnom i kardiovaskularnom sistemu (RS-145001)

DOI: 10.1007/s11096-009-9359-z

ISSN: 0928-1231

PubMed: 20039207

WoS: 000275799200008

Scopus: 2-s2.0-77953321526
[ Google Scholar ]
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URI
http://farfar.pharmacy.bg.ac.rs/handle/123456789/1379
Collections
  • Radovi istraživača / Researchers’ publications
Institution
Pharmacy

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