Drug audit in Hong Kong with special reference to antibiotics

Abstract

In Hong Kong, antibiotic orientated audits have been conducted with respect to (1) the use of paediatric tetracyclines, and (2) ward usage of expensive antibiotics. Consistent with the very high local prevalence of discolouration in the secondary dentition among young persons in the early 1980s, the use of paediatric tetracyclines (sales of liquid formulations) was more than ten-fold greater than the corresponding usage in the UK (inferred from retail prescription surveys). With educational efforts and feedback of such data to doctors, follow-up audits confirm a dramatic reduction in such use of tetracyclines in Hong Kong. A one-month audit of expensive antibiotic administration and dispensing in a single medical ward of Queen Mary Hospital revealed that: (a) much larger amounts of β-lactams were dispensed than administered to patients, and (b) the amount of Unasyn® being given intravenously was probably excessive, considering the good oral bioavailability of this pro-drug. Possible reasons for these anomalies, their expenditure implications and appropriate steps to correct them are discussed.