Drug utilization review of mupirocin ointment in a Korean university-affiliated hospital.
10.3904/kjim.2015.30.4.515
- Author:
Sung Hee YOUN
1
;
Seung Soon LEE
;
Sukyeon KIM
;
Jeong A LEE
;
Bum Joon KIM
;
Jounghee KIM
;
Hye Kyung HAN
;
Jae Seok KIM
Author Information
1. Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea. hushh93@hallym.or.kr
- Publication Type:Original Article
- Keywords:
Drug utilization review;
Mupirocin;
Drug resistance, bacterial;
Methicillin-resistant Staphylococcus aureus
- MeSH:
Administration, Cutaneous;
Anti-Bacterial Agents/*administration & dosage/adverse effects;
Drug Prescriptions;
Drug Resistance, Multiple, Bacterial;
Drug Utilization Review;
*Hospitals, University;
Humans;
Inappropriate Prescribing/*trends;
Methicillin-Resistant Staphylococcus aureus/*drug effects;
Microbial Sensitivity Tests;
Mupirocin/*administration & dosage/adverse effects;
Ointments;
Practice Patterns, Physicians'/*trends;
Predictive Value of Tests;
Republic of Korea;
Retrospective Studies;
Staphylococcal Skin Infections/diagnosis/*drug therapy/microbiology;
Time Factors
- From:The Korean Journal of Internal Medicine
2015;30(4):515-520
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Intranasal mupirocin and chlorhexidine bathing are candidate strategies to prevent healthcare-associated infections caused by methicillin-resistant Staphylococcus aureus (MRSA). In Korea, intranasal mupirocin is not available, and mupirocin ointment, an over-the-counter drug, has been used indiscriminately. Furthermore, because it is covered by health insurance, mupirocin is easy to prescribe within hospitals. METHODS: We performed a mupirocin drug utilization review (DUR) within Hallym University Sacred Heart Hospital. Annual use of mupirocin was investigated between 2003 and 2013, and monthly consumption of mupirocin was assessed during the final 2-year period. The DUR focused on August 2012, the period of highest use of mupirocin. Also, we investigated trends in mupirocin resistance in MRSA between 2011 and 2013. RESULTS: Annual consumption of mupirocin increased from 3,529 tubes in 2003 to 6,475 tubes in 2013. During August 2012, 817 tubes were prescribed to 598 patients; of these, 84.9% were prescribed to outpatients, and 77.6% at the dermatology department. The most common indication was prevention of skin infections (84.9%), and the ointment was combined with systemic antibiotics in 62.9% of cases. The average duration of systemic antibiotic administration was about 7.8 days. The rate of low-level mupirocin resistance in MRSA increased from 8.0% to 22.0%, and that of high-level mupirocin resistance increased from about 4.0% to about 7.5%. CONCLUSIONS: Inappropriate use of mupirocin is prevalent. Considering the increase in resistance and the future application of intranasal mupirocin, prophylactic use of mupirocin in dermatology departments should be reconsidered.
