Drug Utilization Evaluation (DUE) represents a continuous and systematic approach aimed at fostering the proper and efficient utilization of medications. Its fundamental aim is to pinpoint the potential issues and the exploration of corresponding resolutions. A retrospective study was employed to assess the judicious utilization of ceftriaxone. The investigation involved a thorough examination of medication records pertaining to 158 patients who underwent ceftriaxone treatment during their hospitalization at medical wards A, B, C, D, and Pulmonology wards of Tertiary Care Hospitals in Peshawar from May 10, 2023, to June 10, 2023. A drug use evaluation was executed to ascertain whether the application of ceftriaxone aligned with the established protocol for its rational use. Seven criteria, specifically indication for use, dosage, prescription type, frequency of administration, treatment duration, treatment type, and the conduction of culture & sensitivity tests, were employed to appraise its utilization. Data was systematically collected using a structured format and assessed against the drug use evaluation clinical guidelines provided by Médecins Sans Frontières (MSF).

A comprehensive review was conducted on 158 patient records receiving ceftriaxone, revealing a notably high prescribing rate (45.01% point prevalence). Ceftriaxone use was predominantly empiric, accounting for 77.8% of cases, with the primary indications being fever workup (14.6%), chronic obstructive pulmonary disease (5.1%), and enteric fever (5.1%). The most prevalent daily administration frequency and mean treatment duration were 2 g (71.5%) and 8.56 days, respectively. Unfortunately, inappropriate utilization of ceftriaxone was prevalent, particularly concerning the duration of drug administration (64.55%) and the absence of culture and sensitivity tests (85.4%). The study underscores the overall inappropriate use of ceftriaxone, attributed to factors such as indications for use, continued empiric use for suspected infections, and empiric fever therapy. This tendency may stem from the practice of administering empiric antibiotics for fever without clear clinical, biochemical, radiological, or microbiological evidence of bacterial infection. Such unwarranted use not only incurs additional medical costs for patients with viral illnesses but also places a financial burden on hospitals. Despite this, the study found that the dose, frequency, and duration of ceftriaxone were generally appropriate. To address these issues, adherence to evidence-based guidelines is crucial, and the presence of clinical pharmacists in all wards is recommended to monitor and ensure the judicious use of ceftriaxone and other antibiotics