Patterns of Intravenous Human Immunoglobulin Administration in a Middle Eastern Teaching Hospital

Background: Drug use evaluation (DUE) helps to investigate and modify the pattern of drug administration with the aim of improving patient care and cost saving. Considering the important indications for intravenous immunoglobulin (IVIG) and its high cost, assessment of its prescription pattern could be helpful in increasing the efficiency of the health system.This study aimed to investigate the pattern of IVIG use in a tertiary teaching hospital. Methods: This retrospective study included all inpatients who received IVIG in spring and summer ۲۰۲۰. The needed information was extracted from patients’ files. Data were analyzed using SPSS and compared with the standard guidelines. Results: A total of ۷۲ patients received IVIG. The indications were “FDA-approved” and “CEDITacknowledged” in ۳۳.۳% and ۶۱.۱% of the cases, respectively, and ۴۵.۸% adhered to the “red” indications of the UK protocol. Moreover, all prescriptions were in accordance with the approved indications of the FDO (Iranian Food and Drug Organization) guideline. Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy, and COVID-۱۹ were the three most common causes of IVIG administration. Additionally, ۶۶.۷% had received the recommended dose regimen and ۵۱.۳% experienced drug side effects requiring some measures. Conclusion: The occurrence of adverse drug reactions in more than half of the studied patients and related costs substantiate the need for enhancing physicians’ refrain from the unnecessary prescription of the IVIG, nursing staff’s knowledge, and the inclusion of a clinical pharmacist in the healthcare team.

Keywords:

IVIG , Immune globulin , DUE , Drug use evaluation , Rational prescription