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Revisiting Guidelines and Inappropriate use of Ticarcillin/ Clavulanate at an Australian Teaching Hospital
Author(s) -
Patterson Tina H,
Unwin Sean,
Looke David FM,
Pillans Peter I,
Loy Lynette M
Publication year - 2011
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/j.2055-2335.2011.tb00866.x
Subject(s) - medicine , ticarcillin , audit , intensive care medicine , pharmacy , emergency medicine , clavulanic acid , family medicine , antibiotics , amoxicillin , management , microbiology and biotechnology , economics , biology
Aim To assess adherence to local ticarcillin/clavulanate prescribing guidelines; to examine the appropriateness of non‐compliant prescribing; and to identify patterns of prescribing that could be improved. Method A convenience sample of patients prescribed ticarcillin/clavulanate was prospectively identified by ward pharmacists over a 9‐week period. Their medication charts were retrospectively reviewed by the drug use evaluation pharmacist and data collected on patient demographics, diagnosis, previous penicillin allergy, microbiology, treatment type and compliance with local guidelines. Ticarcillin/clavulanate use that was considered inappropriate was analysed for costs. Results Of the 100 patients included in the audit, half were prescribed ticarcillin/clavulanate outside of local guidelines. In this non‐compliant group, approximately two thirds (65%) of patients were considered to have been treated appropriately. The majority of these patients were being managed for diabetic foot infections. Prescribing in only 18% of cases was considered to be neither compliant with the guidelines or appropriate. Pharmacoeconomic analysis suggests that efforts to improve prescribing may result in cost savings. Conclusion There was widespread use of ticarcillin/ clavulanate outside of the local guidelines. In many cases, non‐compliant prescribing was considered appropriate.