Drug Utilization Evaluation of Meropenem and Vancomycin In Febrile Neutropenic Patients

Abstract

Background: Cancer patients treated with Cytotoxic chemotherapy drugs are prone to develop febrile neutropenia which is a major cause of infection, requires a prompt and effective use of broad-spectrum antibiotics to prevent infection related mortality and morbidity. The purpose of present study is to evaluate the use Meropenem and Vancomycin in Febrile Neutropenia (FN) patients. Materials and Methods: A prospective observational study conducted in hematological oncology ward between February 2014 - July 2014. Results and discussion: A total of 113 patients’ fulfilled the inclusion criteria, were recruited for the study. The percentage of males and females was found to be 62.83% and 37.16% respectively. The median age of patients was 50 years (ranges from 20 - 80 years). In our study Meropenem and Vancomycin were started empirically in 84.2%, Specific in 15.5% patients. The result shows that Empiric therapy was justified in most of the cases (72%), but continuation of treatment according to the culture reports in several cases was unjustified (45%). Regarding drug utilization monitoring, we observed that out of 34 patients, 21(33.87%) patients were dose adjusted with Meropenem and 2(9.09%) patients with Vancomycin therapy, based on baseline blood urea nitrogen and serum creatinine assessment and 11(17.74%) patients were not adjusted with Meropenem. The gram-negative bacteria (59.4%) are most commonly isolated in our study followed by gram-positive bacteria (40.5%). Conclusion: Drug use evaluation studies should be performed as a routine program in hospitals by the clinical pharmacist to evaluate and improve the quality of patient care, especially in treatment with antimicrobial agents.