Drug Use Evaluation of Cefepime in Ambo University Referral Hospital, West Shewa, Oromia, Ethiopia

Abstract

Background: Cefepime is a fourth-generation class, broad-spectrum cephalosporin. In contrast to older cephalosporins, cefepime penetrates the gram-negative cell more rapidly, targets multiple essential penicillin-binding proteins, and escapes the effects of many beta-lactamases due to the enzyme’s low affinity for the drug. However, it should be used judiciously because unnecessary, improper, and prolonged use may lead to the emergence of cefepime-insensitive bacteria and risk decline in its efficacy. Therefore, this study is aimed at evaluating the use of cefepime and its efficacy, dose, duration, frequency, contraindication, and drug interaction. The aim of this study was to evaluate the use of cefepime in AURH from January 1 to 25, 2024.

Methods: A cross-sectional study was conducted in AURH by using a questionnaire to collect data from patients’ medical history records from January 1 to 25, 2024, to evaluate cefepime use as per the standard treatment guideline.
Results: From a total of 64 patient medical cards on follow-up, 55 were found to have complete information. Cefepime was correctly indicated for 87.3% of cases, and 23.7% were incorrectly indicated. For 31 (56.45%) patients cefepime was dosed as 50 mg/kg BID or TID; for 21 (38.1%) patients it was 2 mg TID, and for 3 patients it was 1 gm TID per day. About 36 (65.5%) of cefepime was given for the period of 7-10 days, followed by 9 (16.4%) for 10-14, 5 (9.1%) for greater than 15 days, 3 (5.5%) for 2-7 days, and 2 (3.6%) for 1-2 days. Among the drugs co-administered with cefepime, vancomycin was the most commonly used (27 (14.1%)). Among interacting drugs, furosemide 5 (2.6%) took the highest frequency, followed by aspirin 3 (1.6%) and warfarin 2 (1.1%).

Conclusion: In this study the use of cefepime for most patients was correctly indicated for 48 (87.3%) cases, and 7 (23.7%) were incorrectly indicated based on the STG of Ethiopia. The majority of inappropriateness was seen with the duration of therapy.