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Currnently, cefotetan represents the only effective cephalosprin against microorganisms that produce the entended spectrum beta lactamase(ESBI). Since Gram negative microorganisms responsible for nosocomial infection are erportedly to possess ESBI activity, establishment of clerarly defined antibiotic-use guideline is therapeutically important. Thus, committed for drug usage in Seoul National University Hospital(SNUH) recommended a restricition in the use of the antibiotics. The guideline, announced to various departments in SNUH in July 1997, states that the cefotetan uses are limited to justiifiable case only. The committee also recommende-drecommended that drug use evaluation(DEU) may be necessary and that cefotetan, currently the reserved class drug, may be re-categorized as the restriction class in case of the lack of compliance in the guideline This survey was carried out to evaluate the compliance of the guideline. The guideline for cefotetan DUE in SNUH essentially follows principles of the DUE criteria of the American Association of Hospital Pharmacist. Some modifications were made to expedite the adaptation For the evaluation, the cefotetan usages during two-month periods were compared(i. e., before the guideline, from July 1996 the September 1996;after the guideline, from July 1997 th September 1997). Cefotetan useage was retrospectivelt compared based on charts of patients underwent surgical procedures in SNUH during the periods. In 292(before the guideline)and 153(after the guideline)patients, percentage of justifiable usage of cefotetan was greatly improved from 34%(i. e., 100 patient, before the establishment of guideline) to 82%(i. e., 126 patients, after the establishment of the guideline.) However, no improvemet was apparent for frequencies of hypersensitive reaction, infection after surgery and adverse reaction Thus, announcement for the guideline of cefotetan usage appear to have positive effects on extent of cefotetan usage and percentage of justifiable cases. However, details of guideline(e. g., duration of drug use)was not clearly defined at the present time; As A RESULT, frequency of adverse reaction and financial burden to patients were not apparently improved. Therefore, aggressive and detailed education efforts appear necessary for a safe and effctive usage of cefotetan.
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