Evaluation of Aminoglycosides Consumption in Open Heart Surgery Based on the Defined Daily Dose Index

Background: Resistance to antibiotics, including aminoglycosides  (AMG) is one of the problems associated with inappropriate administration of broad-spectrum antibiotics. Objectives: This study aimed to assess the clinical features of aminoglycosides consumption based on the Defined Daily Dose (DDD) index in open heart surgery. Methods: This study was done on ۲۶۸ patients who underwent heart surgery during ۲۰۱۵ and ۲۰۱۶. Clinical and demographic characteristics, laboratory data, and aminoglycoside-related data such as dose and the total duration of administration were collected through a questionnaire designed by the authors. The patients’ DDD/۱۰۰ bed-days were calculated, too. Results: Out of ۲۶۸ patients, ۱۷۰ patients (۶۳.۴%) were male. The Mean±SD age of the patients was ۶۰.۶۵±۱۰.۷۱ years and the Mean±SD duration of hospitalization was ۱۲.۱۹±۷.۰۲ days. Ischemic heart disease was the most prevalent cause of hospitalization. The Mean duration of receiving aminoglycosides was ۳.۶۱ days. In ۱۳۴ patients (۵۰%), creatinine clearance was less than ۶۰ mL/min during aminoglycosides administration. In ۲۵ patients (۹.۳۲%), a ۵۰% increase in serum creatinine during receiving aminoglycosides was observed. Creatinine clearance had not been calculated for any patient. Conclusion: In this study, monitoring the side effects of aminoglycosides and the serum concentration was not routinely performed. Dose adjustment of aminoglycosides based on renal function test was not considered in a large number of patients and as a result, the dose was inappropriate in many patients. Therefore, it is recommended that the guidelines of drug usage were followed and the patients were monitored more closely for side effects.

Keywords:

Intensive Care Units (ICU) , Rational use , Cardiac surgery , Microbial resistance , Prophylactic antibiotic , Aminoglycosides , Defined Daily Dose (DDD)