Comparison between package insert 'full disclosure' suggested utilization of selected intravenous antibiotics with patient chart indications and contraindications

Need for drug utilization review studies has been indicated by research showing irrational utilization of drugs, ranging from misuse to abuse. The primary purpose of this study is to compare utilization of selected intravenous antibiotics as found in patient chart indications with indications listed in appropriate package inserts. Secondarily, it is to study prescribing patterns of physicians for relationships between variables of patient race, sex, pay status and attending physician training status. Furthermore, this work will provide a foundation for similar drug utilization studies. The study hospital was an over-500 bed, short term, general, non-profit institution. Patients receiving intravenous antibiotics were identified and a chart-review system was used to obtain data. Based upon preliminary data, charts of patients receiving ampicillin or cephalothin were chosen to review. When all data was collected, it was determined whether or not the antibiotic was given: (1) prophylactically, or (2) 'for cause' and whether or not there was agreement with package insert indications. Contraindications were also reviewed to determine agreement. Findings indicate 29.4% of the therapy studied is in agreement with package insert indications, combining prophylactic and disagreement scores. This is significant from chance at the .05 level using chi square. Disregarding prophylactic therapy, 56.4% is in agreement. This is not significant from chance at the .05 level using chi square. Of the therapy studied, 92.8% is in agreement with package insert contraindications. This is significant from chance at the .05 level using chi square. Factorial analysis of variance of the dependent variable agreement scores and independent variables of patient race, sex, pay status and attending physician training status showed significant differences only for the last two variables listed.