Utilization review of systemic antiinfective agents in a teaching hospital in Tehran, Iran

Objectives: To investigate the pattern of systemic antiinfective use in Bouali teaching hospital (BH) within a standardized methodology. Methods: To perform a standardized and repeatable study. the Anatomic-Therapeutic-Chemical classification and defined daily dose (ATC/DDD) methodology was used for the first time in Iran. The number of systemic antiinfectives (J class) prescribed for inpatients over a period of 6 months was converted to DDDs. DDD per 100 bed-days was used as a quantitative indicator, and the expenditure share of these drugs was computed. Data were compared with those of similar studies in other countries. Results: Total prescription of systemic antiinfectives was 101.92 DDD/100 bed-days, of which 62% related to parenteral forms, 58% to broad-spectrum agents, and 40.2% to broad-spectrum parenteral agents. The five most commonly used drugs were ampicillin, cefazolin, ceftizoxime, gentamicin, and cefalexin. Antiinfectives prescribed for inpatients accounted for 25.2% of total drug sales of the hospital pharmacy. Most prescriptions occurred in infectious diseases ward, followed by the intensive care unit, gynecology, obstetrics, and ear-nose-throat wards. Conclusion: Prescribing patterns in different wards, relationships between use and cost, and monthly variations are identified and discussed. High utilization rate and irrational prescription of antiinfectives in BH, along with inadequate hospital and national drug policies may be concluded from this study. Drug utilization research study is a useful tool to highlight patterns of drug use.