Investigating the compliance of Carbapenem antibiotics (Meropenem and Imipenem) administration in patients undergoing open heart surgery with the standard guidelines of antibiotic stewardship

This study was conducted to examine the compliance of the administration of Carbapenems in patients undergoing open heart surgery with antibiotic monitoring guidelines of the Ministry of Health and Medical Education in Iran.

Antibiotic resistance is a significant challenge for healthcare systems and can lead to increased costs, prolonged treatment duration, and higher mortality rates among hospitalized patients.

This cross-sectional descriptive study included 70 patients (35 women and 35 men) who underwent heart surgery between March 2021 and the end of August 2021 at Shahid Rajaei Heart Hospital in Tehran, Iran. Data were collected through direct patient interactions and reviewing patients' medical records and were analyzed using SPSS software version 26.

The data revealed that 81 percent of patients received appropriate Carbapenem prescriptions, while 19 percent received an incorrect prescription. The most prescribed antibiotic, with a frequency of 92.9 percent, was Meropenem, and the average number of antibiotics prescribed for each patient was 1.87. The highest rate of Carbapenem prescription was observed in patients with ventilator-induced pneumonia (55.7 percent) and those undergoing coronary artery bypass graft (CABG) surgery (45.7 percent). Approximately 55.7 percent of patients required dose adjustments 72 hours after receiving Carbapenem due to increased creatinine clearance, and 15.7 percent needed to discontinue the drug. The most common causative infection agents were Candida Albicans, Klebsiella Pneumoniae, and Staphylococcus Aureus, respectively.

Antibiotic management programs can limit the irrational use of antibiotics such as Carbapenems and help improve the treatment of infections by preventing the development of antibiotic resistance.