Rational Use of Amikacin in Buali-Sina Hospital in Sari 2011

Background and Inappropriate and irrational prescription of antimicrobial agents is a major concern around the world. Almost half of the prescribed antibiotics are inappropriate and unreasonable. Widespread use of Aminoglycosides is seen in the northern region of Islamic Republic of IRAN. This study aimed at investigating the consumption patterns, indications for use, dosage and intervals, complications, and monitoring of this class of drugs. This retrospective study has been done in 100 patients who received amikacin in Sari Buali-sina Hospital, 2011. Demographic and other information regarding the time of starting antibiotic therapy, antibiotic therapy duration, amikacin dosage and interval, and creatinine clearance were recorded. SPSS V.16 was used to analyze the data. Independent samples t-test and chi square were used to compare the quantitative and qualitative variables, respectively. Among the patients 53 (53%) were less than one week of age, of whom 61% were male. The mean of starting antibiotics was 1.06 ± 0.307 days in neonates, and 1.19±0.616 days in infants. The mean duration of starting treatment with antibiotics in neonates was 12.95± 12.237 days and 6.57± 4.01 in infants. The average duration of amikacin in neonatal and infants was 4.89±4.05 and 9.83± 5.43 days, respectively. Serum creatinine levels were measured in17 patients before, during and after using amikacin. In 30% of patients the correct dosage based on serum creatinine levels was not prescribed. The mean of baseline serum creatinine was 0.603 ± 0.122 in neonates and 0.625 ± 0.103 in infants (Pv=0.95). This study showed irrational use of amikacin and the main problem found in this study was not considering renal function, co-administration of drugs, and nephrotoxic. We believe that referral centers should be created in the region on a daily basis in order to measure the drug level.