Benzodiazepine use in a small community hospital. Appropriate prescribing or not?

Benzodiazepine (BDZ)-prescribing patterns in relation to indications and to drug characteristics in a small short-stay hospital were examined. In a sample of 800 patients, 183 were prescribed BDZs during their stay. Female patients received more BDZs (BDZ:female patients 1.31:1.0) than males (BDZs:male patients 1.02:1.0), particularly in the 21-40-year age group in which polypharmacy was highest. BDZs were classified according to their elimination half-lives. Our data showed that the majority fell into the long-acting (half-life greater than 24 h) (55%) and intermediate-acting (half-life 12-24 h) (20.7%) categories, despite the fact that most indications (pre-anaesthetic and night-time sedation; total 71.6%) called for the shorter-acting drugs. The merits or otherwise of this situation are discussed, and a number of questions put regarding the validity of this approach. Overall, BDZs accounted for 5.8% of the calculated medications given to the 800-patient sample.