Colistin Utilization Evaluation in a Major Teaching Hospital in Iran

Background: Colistin is an old antibacterial agent which is used in multiple drug resistant (MDR) infections. Due to increased rate of MDR infections, the use of this agent is raised in worldwide. The aim of this study was to identify colistin utilization patterns in a teaching hospital. Methods: This retrospective cross-sectional study was performed between Augusts 2017 and December 2017 at Firoozgar hospital affiliated to Iran University of Medical Sciences, Tehran, Iran. All colistin prescriptions for adult patients during the study period were enrolled for appropriateness evaluation according to the Lexi comp acquired by Wolters Kluwer and National Health Service (NHS) guideline. Results: Among 70 patients who received colistin, pneumonia (70%) was the chief indication of colistin prescription. In 96% of cases, colistin was prescribed according to microbiological laboratory results. In 14% of patients, colistin administration was before providing microbiological laboratory evidence. Seventeen percent of the patients received loading dose of colistin. The interval between loading and maintenance doses were incorrect in all of these patients. 73% and 67% of the prescribed doses at the initiation and end of colistin therapy were appropriate. The time interval and duration colistin therapy were appropriate in 78% and 52% of patients, respectively. The mean of creatinine clearance reduced statistically significant, 81.95 ± 39.89 and 70.85 ± 38.80 in the first and end of days of colistin therapy, respectively (P: 0.004). Conclusion: These findings support the requirement for physicians’ educational programs and suitable strategies for appropriate prescriptions.