Clindamycin Stewardship: An Opportunity for Hospitalized Patients in Razi Hospital, Rasht, Iran

Background: In hospitalized patients, the most common used drugs are antibiotics. Programs designed to rational use of antibiotics improve the quality of care and infection management, and reduce costs. 
Aims and Objectives: The objective of this study was to assess the rational use of clindamycin in Razi Hospital, Rasht, Iran. 
Materials and Methods: This retrospective cross-sectional study was performed in Razi Hospital, Rasht, Iran. All hospitalized patients who received clindamycin were included. Patient’s demographic, duration of use and dose of clindamycin therapy, and other concomitant antibiotics were collected from patients’ medical records. Rational clindamycin prescribing was evaluated based on recommendations of UpToDate software, version 21.6, Waltham, MA, United States. Analysis of data was performed by the Statistical Package for the Social Sciences software, version 16.0. 
Results: A total of 607 patients receiving clindamycin during 15 months of study were evaluated. The mean age of the patients was 51.51 ± 15.92 years (range: 16–87 years). The most hospitalized patients receiving clindamycin were in internal ward (86%). The most frequently coadministered antibiotics with clindamycin were third-generation cephalosporins (47.9%). The majority of patients admitted in the winter (40.4%). The most frequently primary and final diagnosis in patients receiving clindamycin was reported pneumonia, respectively, 33.1% and 32.1%. Indication, dose, and duration of clindamycin were appropriate in 583 (96%), 277(47.5%), and 208 (35.7%) patients, respectively. 
Conclusion: The rate of incorrect dose and duration of clindamycin in our hospital were significantly high. Also, the majority of its prescription were as off-label indications. Programs for more justified administration of clindamycin to improve quality of care and decrease antibacterial resistance and cost are necessary.