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Khalili H, Gholami Kh, Hajiabdolbaghi M, Sairafipoor Z,
Volume 64, Issue 12 (11-2006)
Abstract

Background: Drug Utilization Evaluation (DUE) studies are performed to define, determine, and finally improve the quality of drug usage. These types of studies are especially valuable for drugs with a narrow therapeutic index or specific indication, or for expensive medications. In Iran, vancomycin is only available by prescription for methicillin-resistant staphylococcal and enterococcal infections. It is obvious that extensive and irrational use of this drug can increase bacterial resistance to this antibiotic. The goal of this study was to assess vancomycin utilization.
Methods: In a descriptive cross-sectional study performed during the fall and winter of 2004, this vancomycin DUE was done in the Infectious Disease Department of Imam Khomeini Hospital in Tehran. All of the patients receiving vancomycin were enrolled in this study. The Centers for Disease Control (CDC) and American Society of Hospital Pharmacists (ASHP) protocols have been used to perform this study.
Results: Of the 565 inpatients at this hospital, 39 subjects (7%) received vancomycin. Vancomycin utilization among these patients was compatible with CDC and ASHP protocols in only 28% and 35% of the patients, respectively.
Conculusion: Vancomycin is predominantly administered empirically, rather than being based on the antibiogram. This may be due to the routine protocol of the ward or the physician doubting the reliability of the antibiogram.
Hasibi M, Soudbakhsh A., Abadi Z, Mehdipoor P,
Volume 65, Issue 10 (1-2008)
Abstract

Background: Infectious diseases are usually treatable however, infectious disease is one of the most common causes of mortality in hospitals. Furthermore, an apparent functional stagnation around the weekends in hospitals can increase the mortality rate. The goal of this study is to describe the causes and predisposing factors of mortality and to evaluate the role of holidays on patient mortality in infectious disease wards.

Methods: In this retrospective descriptive-analytic study, we examined the files of patients who had expired while hospitalized in the infectious disease ward of Imam Khomeini Hospital from 2002 to 2004. All of the information was gathered from patient files and the mortality committee of Imam Khomeini Hospital. Patient mortality rates were determined for each year. Mortality rates for the various days of the week were estimated and compared for 2004.

Results: The total number of patients included in this study was 3979. Of these, 216 cases had expired, 143 of whom were male (66%). The common causes of mortality were sepsis (26%) bacterial pneumonia (22%) and tuberculosis (19%). The mortality rates were 5.08%, 5.31% and 5.84% in 2002, 2003 and 2004, respectively. In 2004, mortality rates were 9.21%, 10.21% and 4.56% for holidays, pre-holidays and other days of week, respectively. A significantly higher rate of mortality was observed for holidays and pre-holidays compared to the other days of week. (P value <0.05).

Conclusions: Fortunately, the mortality rate of 5.43% in this infectious disease ward was not high. Since sepsis, bacterial pneumonia and tuberculosis were the most common causes of mortality, extra care of patients with these diseases is necessary. As a result of the findings of this study, we recommend increasing expert hospital staff and improving the quality of diagnostic and treatment services during holidays and pre-holidays.



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