Study on prescribing patterns of parenteral antibiotics in medical and surgical units of Hospital Batu Pahat

Objective: To determine the prescribing patterns of parenteral antibiotics in the medical and surgical units of Hospital Batu Pahat including the single agent and combination agent used most frequently for the treatment, the most commonly used agent, the most common infection treated and the antibiotics used, and the total cost spent on parenteral antibiotics.

Methods: Medical records of all patients who received parenteral antibiotic therapy whilst in the medical and surgical units of Hospital Batu Pahat between 1st December, 2008 and 31st January, 2009 were reviewed. A data collection form was used to collect data on those patients ( please refer to appendix at the last page ).

Subject: 131 patients who received parenteral antibiotic therapy in medical unit and 159 patients in surgical units during the study period were taken into account for this study.

Result: The top three parenteral antibiotics used in the medical and surgical units were Metronidazole (85/290, 29.3%), Amoxicillin plus Calvulanic acid (Augmentin) (76/290, 26.2%), and Ampicillin plus sulbactam( unasyn ) (65/290,22.4%) injection. Augmentin injection (45/131, 34.4%) was the most frequently used single agent for the treatment in medical units whereas unasyn injection (37/159, 23.3%) was the most frequently agent used in surgical units. The combination of Cefoperazone plus Metronidazole was widely used in both medical (5/131, 3.8%) and surgical units (31/159, 25.8%). Most commonly treated infections in medical units were respiratory tract ( 42/131, 32.1 %) and cardiovascular infection (24/131, 18.3%) which were usually treated with Augmentin 1.2 g tds. Gastrointestinal infections (44/159, 27.7%) and endocrine system infections (21/159, 13.2%) were the major indications for parenteral antibiotic therapy in surgical unit. For gastrointestinal infection, the combination of Cefoperazone I g bd and Metronidazole 500 mg qid was usually used for the treatment or as prophylactic agent while Unasyn 1.5 g tds was used as prophylactic agents for endocrine infection. Unasyn injection (RM 6709.56/ RM34118.12, 19.7%) accounted for a major part of the total cost spent for parenteral antibiotics in both medical and surgical units during the study period.