Ertapenem의 약물사용 평가
Drug Use Evaluation of Ertapenem
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Ertapenem is one of the carbapenem antibiotics, which is effective for organisms that produce β-lactamase. It is useful in that it can be administrated once a day and used without any combination antibacterial therapy. In practice, it is reserved primarily for use as a second line drug or against Extended spectrum beta-lactamase (ESBL)-producing by bacteria. There have been measures to prevent the expression of antibiotic-resistant bacteria. Also, Seoul National University Hospital (SNUH) regulated the approval from the professor of the Infection Department for prescribing some antibiotics, including ertapenem. The object of this study was to investigate and evaluate the pattern of ertapenem usage, which is properly followed by the standard of national medical insurance of ertapenem in SNUH. A retrospective study used 73 cases and was performed on 66 patients aged over 18 years of age who were administered ertapenem for longer than 3 continuous days at SNUH, from January 1, 2010 to June 30, 2010. The mean duration of administration was 12±7.5 days. The microorganisms treated with ertapenem were E.coli(60.3%), K.pneumoniae(31.5%) and E.cloacae(5.5%) and the infected site were urinary tract(43.8%), wound(24.7%) blood(17.8%), and etc. Most cases (70 cases, 95.9%) met with the criteria for the justification of use. In 70 cases (95.9%), blood culture and sensitivity(C&S) test were performed less than, 7 days before the first administration. In all cases (73 cases, 100%), white blood-cell count(WBC) was tested ahead of the dosing, and body temperature was monitored at least three times a day during administration. In 69 cases (94.5%), serum creatinine were checked. In 65 cases, the dosage regimen was appropriated. In 69 cases (94.5%), ertapenem is effective on infection. The relapse that occurred in the same microorganism was in 20 cases (27.3%) and secondary infection was in 21 cases (28.8%). Drug-related adverse effects were reported in 13 cases (diarrhea, dermatologic reaction, seizure, diarrhea caused by C.difficile.). Ertapenem is a drug that needs renal dosing, thus the kidney function is needed to be concerned when inspecting prescriptions. Also, it is important to keep the proper dosage and duration followed by indication in order to prevent resistance and relapse.
Abstract
Ertapenem is one of the carbapenem antibiotics, which is effective for organisms that produce β-lactamase. It is useful in that it can be administrated once a day and used without any combination antibacterial therapy. In practice, it is reserved primarily for use as a second line drug or against Extended spectrum beta-lactamase (ESBL)-producing by bacteria. There have been measures to prevent the expression of antibiotic-resistant bacteria. Also, Seoul National University Hospital (SNUH) regulated the approval from the professor of the Infection Department for prescribing some antibiotics, including ertapenem. The object of this study was to investigate and evaluate the pattern of ertapenem usage, which is properly followed by the standard of national medical insurance of ertapenem in SNUH. A retrospective study used 73 cases and was performed on 66 patients aged over 18 years of age who were administered ertapenem for longer than 3 continuous days at SNUH, from January 1, 2010 to June 30, 2010. The mean duration of administration was 12±7.5 days. The microorganisms treated with ertapenem were E.coli(60.3%), K.pneumoniae(31.5%) and E.cloacae(5.5%) and the infected site were urinary tract(43.8%), wound(24.7%) blood(17.8%), and etc. Most cases (70 cases, 95.9%) met with the criteria for the justification of use. In 70 cases (95.9%), blood culture and sensitivity(C&S) test were performed less than, 7 days before the first administration. In all cases (73 cases, 100%), white blood-cell count(WBC) was tested ahead of the dosing, and body temperature was monitored at least three times a day during administration. In 69 cases (94.5%), serum creatinine were checked. In 65 cases, the dosage regimen was appropriated. In 69 cases (94.5%), ertapenem is effective on infection. The relapse that occurred in the same microorganism was in 20 cases (27.3%) and secondary infection was in 21 cases (28.8%). Drug-related adverse effects were reported in 13 cases (diarrhea, dermatologic reaction, seizure, diarrhea caused by C.difficile.). Ertapenem is a drug that needs renal dosing, thus the kidney function is needed to be concerned when inspecting prescriptions. Also, it is important to keep the proper dosage and duration followed by indication in order to prevent resistance and relapse.
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