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Irrational use of medicines is a major problem worldwide. Since iodixanol (Visipaque®) was categorized in Category I based on the ABC-VED analysis in our hospital, we evaluated the amount of visipaque use and estimated the incremental cost based on the Maximum Contrast Dose (MCD) following irrational use of contrast media. This retrospective study was conducted on 100 admitted patients aged 18 to 80 years old undergoing elective Percutaneous Coronary Intervention (PCI) who received visipaque during February 2016 to January 2017. All of the patients’ information was collected from medical records and Hospital Information System (HIS). MCD was calculated by using the formula proposed by Cigarroa and colleagues: MCD (mL) =5× body weight (kg)/ Serum Creatinine (SCr) (mg/dl). The amount of contrast media administered ranged from 200 to 600 mL (mean, 348 mL ± 80). 57 % of patients received the visipaque more than MCD. Only 25 patients were evaluated SCr after PCI and in 11 (44%) of these patients SCr increased and 3 (12%) patients developed CI-AKI. Consumption of the contrast media was 2 to 3 times more than previous studies which could be the cause of acute kidney injury besides the extra cost. In our study about six liters more of contrast agent was used which is more than standard values with a cost of approximately $2,000 for 100 patients. Therefore, in order to reduce costs and complications, appropriate clinical protocol of contrast media, more supervision on medical residents and contrast infusion pumps, as well as a periodic evaluation study are highly recommended.

Background: Resistance to antimicrobial agents including aminoglycosides (AGs) is a great concern that is mainly related to inappropriate use. Since there were not adequate data regarding how rationally AGs are being prescribed in our critically ill patients, this study was conducted to determine the main issues in the area of appropriate use of this antibiotic class. Methods: One hundred patients who were in the intensive care units (ICUs) of Imam Khomeini Teaching Hospital from February 2012 to August 2012 were included. A data gathering form was prepared based upon the recommendations provided by Up-to-date (20.1) 2012 and Medscape 2013. All demographic characteristics and other information about time of beginning and duration of dosage, interval of administration of AGs and creatinine (Cr) level were collected. In statistical analysis, SPSS Version 16 software was used. Independent samples t-test was used to compare the quantitative and chi-square for qualitative variables. Results: Sixty six (66%) of patients received gentamicin and 38% received amikacin. In 27% of patients, serum creatinine (Cr) had been checked before and after AGs administration and 4 patients had no renal function monitoring. Monitoring of serum concentration and Cr clearance estimation was not carried out for any patients. Culture and laboratory sensitivity tests were done on 17 patients and E-coli (57%) was the most common isolated organism. Conclusion: The results of this study revealed that majority of the hospitalized patients in the ICU and the dosage of AGs had not been adjusted to renal function.