新生儿重症监护室抗生素的合理使用（英文PPT）Rational drug use of antibiotics in a Neonatal Intensive Care Unit.ppt

Rational drug use of antibiotics in a Neonatal Intensive Care Unit Dr N Schellack, Prof AGS Gous Department of Pharmacy University of Limpopo (Medunsa Campus) Introduction Rational Drug use in the NICU is defined as According to Quick et al (1997:422) RDU includes the following criteria: Correct drug Appropriate indication Appropriate dosage, administration, and duration of treatment; Appropriate patient Correct dispensing - this includes correct dispensing Patient’s adherence to treatment. Background Following recurrent outbreaks of neonatal Candida in the NICU prompted the management of the hospital to investigate the use of antibiotics in the NICU, to eliminate the likelihood that irrational use of antibiotics might have been one of the causes. Antibiotic protocol First line: Penicillin 100 000 IU/kg/dose and Amikacin 25 mg/kg/dose (LD) and maintenance dose of 20 mg/kg/dose Second line Piperacillin and Tazobactam (Tazocin) 50 mg/kg/dose Third line Meropenem 20 mg/kg/dose administered 12 hourly Fourth line Ciprofloxacin 10 – 20 mg/kg/dose administer in 2 doses 12 hourly Methods Results … What antibiotics were used and how were they administered – “Correct drug” Of the 100 patients followed, 95 patients received intravenous antibiotics, of which 91 received antibiotics included in the units protocol Four patients received alternative antimicrobial therapy (e.g. tobramycin and ceftazidime) as required by their clinical conditions and sensitivity results. Results Results … Results … Results … Duration of antibiotic use Methicillin-resistant Staphylococcus aureus (MRSA) Ten of 91 patients who were given antibiotics from the ward protocol received vancomycin. For all ten of these patients laboratory sensitivity cultures had been requested and the vancomycin was instituted following the positive sensitivity results for MRSA. Results … Results… Proposed process for providing pharmaceutical care: Conclusion … Antibiotics were used according to the ward pro