Determining the Amount of Prescribing and Consumption of Colistin in the Control of Common Bacterial Infections
Subject Areas : Journal of Comparative PathobiologyMohammad Tahmasebifar 1 , Seyed Reza Abtahi 2 , Mohammad Darvishi 3
1 - 1. Student Research Committee, AJA University of Medical Sciences, Tehran, Iran
2 - Department of Pharmacology and Toxicology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
3 - 2. Infectious Diseases and Tropical Medicine Research Center (IDTMRC), Department of Aerospace and Subaquatic Medicine, AJA University of Medicinal Sciences. Tehran, Iran
Keywords: Colistin, Antibiotic, Special wards,
Abstract :
Colistin is used in antimicrobial resistance. The use of colistin has increased with the rise in antibiotic resistant infections. The aim of this study is the investigation of colistin consumption patterns before and after the implementation of the stewardship plan. Records of patients treated with colistin in the intensive care unit, internal, orthopedics and nephrology wards of Besat Hospital were reviewed. 65 cases before the implementation of the plan and 65 cases after the implementation were evaluated and checked for prescription indications, prescribed dosage, drug interactions, prescription based on microbial sensitivity to colistin. Data were analyzed using SPSS version 26. Colistin was prescribed before the plan in 23.1% of cases before microbial sensitivity assay. During the plan, in 9.2% of cases, colistin was prescribed without a culture request (p=0.027). Before the plan, there was no indication for prescribing colistin in 26.2% of patients, and during the plan, there was no indication for prescribing in 7.7% of patients (p=0.004). Before the plan, the dose of colistin was 23.1% more than the standard. During the plan, the dose of colistin was higher than the standard in 9.2% of cases (p=0.032). Before the plan, simultaneous administration of colistin with nephrotoxic drugs was in 10.8% of cases and during the plan, interaction between colistin and nephrotoxic drugs was 4.6% (p=0.16). After the plan, interactions of colistin with nephrotoxic drugs, dosage adjustment, identification of prescription indications and prescription based on culture were significantly different from before the implementation of the plan.
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