Evaluation of the appropriateness of meropenem prescribing at a tertiary care hospital: A retrospective study in Oman

Objectives: The aim of this study was to evaluate the use of meropenem in terms of indication and continuation of treatment at Sultan Qaboos University Hospital (SQUH), Muscat, Oman. Methods: A retrospective observational study, conducted by reviewing the medical records of 400 adults, admitted patients who received at least one dose of meropenem during the study period (January 2017 to September 2017). The analysis was performed using univariate statistics. Results: Meropenem was prescribed empirically in 382/400 (96%) of the cases. The majority (315/361 (87%)) of the patients received the proper meropenem dose. The indication for meropenem was considered appropriate in only 196/400 (49%) of the cases. The continuation of treatment was evaluated according to culture and sensitivity results in 202 cases, out of which 112 (55%) were justified. Most of the inappropriate uses were seen in oncology and hematology cases (31/42 (74%) and 61/101 (60%), respectively) and among respiratory and urinary tract infections (126/155 (81%) and 40/46 (87%), respectively). Conclusions: Approximately half of the meropenem orders at SQUH in Oman were inappropriate and unjustified by culture-test results. New strategies are needed to optimize the rational use of meropenem and to ensure appropriate de-escalation and discontinuation of meropenem whenever indicated. (C) 2020 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.