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VIKTOR DOMBROVSKIY, M.D., PH.D., M.P.H., is Assistant Professor of Medicine; ANDREW MARTIN, M.D., is Associate Professor of Medicine; JAGADEESHAN SUNDERRAM, M.D., is Assistant Professor of Medicine; and HAROLD PAZ, M.D., is Professor of Medicine, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, New Brunswick, NJ.

Address correspondence to Dr. Dombrovskiy at the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, 125 Paterson Street, Suite 1400, New Brunswick, NJ 08903 (dombrovy{at}umdnj.edu).

Purpose. The use of drotrecogin alfa (activated) for the treatment of severe sepsis in acute care hospitals in New Jersey was evaluated. Summary. An observational study was conducted to determine the prevalence of severe sepsis and drotrecogin alfa use in hospitalized patients in New Jersey. In November 2003, a survey was mailed to the pharmacy directors of 84 acute care hospitals (teaching, major teaching, nonteaching) in New Jersey to collect information about the monthly use of drotrecogin alfa in 2002 and 2003. Health Care Financing Administration Uniform Bill of 1992 patient discharge data from New Jersey for the same period were analyzed to identify patients with severe sepsis and calculate the rate of drug use for their treatment. The survey received a total response rate of 55%. Among 7292 patients with severe sepsis who were treated in 2002 in participating hospitals, 137 received drotrecogin alfa. From January 2003 to October 2003, the average rate of drotrecogin alfa use in the same hospitals was identical. Drug use in teaching and major teaching hospitals was greater than in nonteaching hospitals. An increase in drotrecogin alfa use in 2003 compared with 2002 was expected; however, a comparison of its use in 2002 and 2003 in New Jersey acute care hospitals found that the rate of drug use remained the same. One tenth of responding hospitals never used drotrecogin alfa during the study period. Conclusion. An observational study showed an apparent underutilization of drotrecogin alfa (activated) for treatment of severe sepsis in acute care hospitals in New Jersey. Index terms: Antiinflammatory agents; Data collection; Drotrecogin alfa; Drug use; Hospitals; Rational therapy; Sepsis

 

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