Article Text

Download PDFPDF
Does the use of new cephalosporins follow the authorised, financed and approved indications? A study of their use in routine clinical practice in a tertiary hospital
  1. Andrés Pintado-Álvarez1,
  2. Lucia Yunquera-Romero1,
  3. Ignacio Márquez-Gómez2,
  4. Rocío Asensi-Díez1
  1. 1 Hospital Pharmacy, Hospital Regional Universitario de Malaga, Malaga, Andalucía, Spain
  2. 2 Infectious Diseases, Hospital Regional Universitario de Malaga, Malaga, Andalucía, Spain
  1. Correspondence to Dr Lucia Yunquera-Romero, Hospital Pharmacy, Hospital Regional Universitario de Malaga, Malaga 29010, Andalucía, Spain; luciayunquera888{at}hotmail.com

Abstract

Objectives To evaluate the appropriateness of ceftazidime-avibactam (C-A), ceftolozane-tazobactam (C-T) and ceftaroline prescriptions according to European Medicines Agency (EMA)/Spanish Agency of Medicines and Medical Devices (AEMPS) approved indications, financed indications in the Spanish health system and hospital Infection Commission (IC) recommendations in a tertiary hospital.

Methods Observational, descriptive and retrospective study of inpatients aged ≥18 years, who were prescribed the above-mentioned antimicrobials during the period January–December 2020. Variables obtained were demographic (sex and age), pharmacological (antibiotic, use – empiric or targeted, indication) and microbiological (sensitivity testing and antibiotic tested) data.

Results A total of 79 patients were included. C-A (n=40): 67.5% of patients were male, with a mean age of 61 (range 22–87) years. Empiric treatment was applied in 30% of the cases (n=12). De-escalation in 33.33% of individuals. Sensitivity testing was done in 92.86% of patients, including C-A in 57.69% of them. C-T (n=19): 89.47% of patients were male, with a mean age of 65 (range 18–82) years. An empiric approach was followed in 5.26% of subjects; de-escalation was performed in all cases due to culture with multidrug-resistant (MDR) Pseudomonas aeruginosa. Sensitivity testing was carried out in 100% of patients, including C-T in 26.32% of them. Ceftaroline (n=20): 70% of patients were male, with a mean age of 55.5 (range 23–79) years. Empiric treatment was applied to 30% of cases. In 50% of these subjects de-escalation was done. Sensitivity testing was done in 92.85% of them, but in none with ceftaroline. Regarding the percentage of appropriateness: approved EMA/AEMPS indications: C-A: 100%; C-T: 84.21%; ceftaroline: 75%; financed indications in the Spanish health system: C-A: 85%; C-T: 100%; ceftaroline: 15%; IC: C-A: 60%; C-T: 57.9%; ceftaroline: 15%.

Conclusions Our results highlight the importance of stewardship programmes in the decision-making process and in the follow-up of patients with infections caused by MDR microorganisms.

  • drug misuse
  • education
  • pharmacy
  • microbiology
  • evidence-based medicine
  • pharmacy service
  • hospital

Data availability statement

Data are available in a public, open access repository. Not applicable.

Statistics from Altmetric.com

Data availability statement

Data are available in a public, open access repository. Not applicable.

View Full Text

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.