Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals

Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals

Background/aim: Most of the hospitalized patients are on a number of drugs for comorbidities and/or to prevent nosocomial infections. This necessitates a careful consideration of drug interactions not only to avoid possible toxicities but also to reach the highest efficiency with drug treatment. We aimed to investigate drug interactions related to systemic antibiotic use and compare three different databases to check for drug interactions while characterizing the main differences between medical and surgical departments. Materials and methods: This point prevalence study covered data on 927 orders for patients hospitalized between June 3 and 10, 2018 in Ankara University Hospitals. Systemic antibiotic use and related drug interactions were documented using UptoDate, Drugs, and Medscape and comparisons between the departments of medical and surgical sciences were made. Results: The number of orders, or the number of drugs or antibiotics per order were not different between the medical and surgical sciences departments. A total of 1335 antibiotic-related drug interactions of all levels were reported by one, two, or all three databases. UptoDate reported all common and major interactions. Pantoprazole was the most commonly prescribed drug and appeared in 63% of all orders. Among 75 different molecules, ceftriaxone and meropenem were the two most prescribed antibiotics by the surgical and medical departments, respectively. Conclusion: A dramatic variance existed amongst antibiotics prescribed by different departments. This indicated the requirement for a centralized role of an infectious diseases specialist. Especially for the hospitalized patient, prophylactic coverage with at least one antibiotic brought about a number of drug interactions. A precise evaluation of orders in terms of drug interactions by a clinical pharmacist (currently none on duty) will reduce possible drug-related hazards.Key words: Antibacterial agents, drug interactions, pharmacist

___

  • 1. Baggs J, Fridkin SK, Pollack LA, Srinivasan A, Jernigan JA. Estimating national trends in inpatient antibiotic use among US hospitals from 2006 to 2012. JAMA Internal Medicine 2016; 176: 1639-1648. doi: 10.1001/jamainternmed.2016.5651
  • 2. Abarca J, Malone DC, Armstrong EP, Grizzle AJ, Hansten PD et al. Concordance of severity ratings provided in four drug interaction compendia. Journal of the American Pharmacists Association 2004; 44: 136-141. doi. 10.1331/154434504773062582
  • 3. McLaughlin JE, Reeves DS. Clinical and laboratory evidence for inactivation of gentamicin by carbenicillin. Lancet 1971; 1: 261-264. doi: 10.1016/s0140-6736(71)91001-4
  • 4. Henderson JL, Polk RE, Kline BJ. In vitro inactivation of gentamicin, tobramycin, and netilmicin by carbenicillin, azlocillin, or mezlocillin. American Journal of Hospital Pharmacy 1981; 38: 1167-1170. doi: 10.1093/ajhp/38.8.1167
  • 5. Holt HA, Broughall JM, McCarthy M, Reeves DS. Interactions between aminoglycoside antibiotics and carbenicillin or ticarillin. Infection 1976; 4: 107-109. doi: 10.1007/bf01638726
  • 6. Davies M, Morgan JR, Anand C. Interactions of carbenicillin and ticarcillin with gentamicin. Antimicrobial Agents and Chemotherapy 1975; 7: 431-434. doi: 10.1128/aac.7.4.431
  • 7. Weibert RT, Keane WF. Carbenicillin-gentamicin interaction in acute renal failure. American Journal of Hospital Pharmacy 1977; 34: 1137-1139. doi: 10.1093/ajhp/34.10.1137
  • 8. Thompson MI, Russo ME, Saxon BJ, Atkin-Thor E, Matsen JM. Gentamicin inactivation by piperacillin or carbenicillin in patients with end-stage renal disease. Antimicrobial Agents and Chemotherapy 1982; 21: 268-273. doi: 10.1128/aac.21.2.268
  • 9. Kradjan WA, Burger R. In vivo inactivation of gentamicin by carbenicillin and ticarcillin. Arch Intern Med 1980; 140: 1668- 1670. doi: 10.1001/archinte.1980.00330230114024
  • 10. Lexicomp Drug Interactions. 2019.
  • 11. ZOSYN® Prescribing Information.
  • 12. Medscape Drug Interaction Checker.
  • 13. Fralick M, Macdonald EM, Gomes T, Antoniou T, Hollands S et al. Co-trimoxazole and sudden death in patients receiving inhibitors of renin-angiotensin system: population based study. British Medical Journal 2014; 349: g6196. doi: 10.1136/ bmj.g6196
  • 14. Fridkin SK, Srinivasan A. Implementing a strategy for monitoring inpatient antimicrobial use among hospitals in the United States. Clinical Infectious Diseases 2014; 58: 401-406. doi: 10.1093/cid/cit710
  • 15. WHO Report on Surveillance of Antibiotic Consumption. 2016 - 2018 Early implementation. World Health Organization, 2018.
  • 16. OECD. Stemming the Superbug Tide: Just A Few Dollars More, OECD Health Policy Studies. Paris, France: OECD Publishing; 2018.
  • 17. İşler B, Keşke S, Aksoy M, Azap OK, Yılmaz M et al. Antibiotic overconsumption and resistance in Turkey. Clinical Microbiology and Infection 2019; 25: 651-653. doi: 10.1016/j. cmi.2019.02.024
  • 18. Charani E, de Barra E, Rawson TM, Gill D, Gilchrist M et al. Antibiotic prescribing in general medical and surgical specialties: a prospective cohort study. Antimicrobial Resistance and Infection Control 2019; 8: 151.doi: 10.1186/ s13756-019-0603-6
  • 19. Szymczak JE. Are surgeons different? The case for bespoke antimicrobial stewardship. Clinical Infectious Diseases 2019; 69: 21-23. doi: 10.1093/cid/ciy847
  • 20. Davey P, Marwick CA, Scott CL, Charani E, McNeil K et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database of Systematic Reviews 2017. doi: 10.1002/14651858.CD003543.pub4
  • 21. Kuscu F, Ulu A, Inal AS, Suntur BM, Aydemir H et al. Potential drug-drug interactions with antimicrobials in hospitalized patients: a multicenter point-prevalence study. Medical Science Monitor 2018; 24: 4240-4247. doi: 10.12659/MSM.908589
  • 22. Reid M, Keniston A, Heller JC, Miller M, Medvedev S et al. Inappropriate prescribing of proton pump inhibitors in hospitalized patients. Journal of Hospital Medicine 2012; 7: 421-425. doi: 10.1002/jhm.1901
  • 23. Craig DGN, Thimappa R, Anand V, Sebastian S. Inappropriate utilization of intravenous proton pump inhibitors in hospital practice-a prospective study of the extent of the problem and predictive factors. Qjm-an International Journal of Medicine 2010; 103: 327-335. doi: 10.1093/qjmed/hcq019 24. Pourmorteza M, Lewis P, Tharp J, Reddy C, Litchfield J et al. Proton pump inhibitors use and risk of Clostridium difficile infection in hospitalized patients. American Journal of Gastroenterology 2015; 110: S588-S588.
  • 25. Zarinafsar S, Matine L, Razzak E, Li K, Kim E et al. Does longterm use of a proton pump inhibitor (PPI) lead to osteopenia or fractures? Journal of Investigative Medicine 2018; 66: 168- 169. doi: 10.1136/jim-2017-000663.246
  • 26. Herzig SJ, Howell MD, Ngo LH, Marcantonio ER. Acidsuppressive medication use and the risk for hospital-acquired pneumonia. Journal of the American Medical Association 2009; 301: 2120-2128. doi: 10.1001/jama.2009.722
  • 27. Anjewierden S, Han Z, Foster CB, Pant C, Deshpande A. Risk factors for Clostridium difficile infection in pediatric inpatients: A meta-analysis and systematic review. Infection Control & Hospital Epidemiology 2019; 40: 420-426. doi: 10.1017/ice.2019.23
  • 28. Blume H, Donath F, Warnke A, Schug BS. Pharmacokinetic drug interaction profiles of proton pump inhibitors. Drug Safety 2006; 29: 769-784. doi: 10.2165/00002018-200629090- 00002
  • 29. Wedemeyer RS, Blume H. Pharmacokinetic drug Iiteraction profiles of proton pump inhibitors: an update. Drug Safety 2014; 37: 201-211. doi: 10.1007/s40264-014-0144-0
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Risk factors predicting the development of diabetes mellitus and metabolic syndrome following gestational diabetes mellitus

Gülşah YENİDÜNYA YALIN, Bülent CAN, Sema ÇİFTÇİ, Nevin DİNÇÇAĞ

Acute necrotizing encephalopathy of childhood: a single-center experience

Hülya KAYALIOĞLU, Mehpare ÖZKAN, Ülkü ÖZTOPRAK, Erhan AKSOY, Halil ÇELİK, Fatih Mehmet Akif ÖZDEMİR, Ayşegül DANIŞ, Özge KUCUR, Mutlu Uysal YAZICI, Ebru AZAPAĞASI, Yasemin TAŞCI YILDIZ, Nesrin CEYLAN, Saliha ŞENEL, Deniz YÜKSEL, Selman KESİCİ

The necessity of treating asymptomatic bacteriuria with antibiotics in the perioperative period of joint arthroplasty: a metaanalysis.

Sayed Abdulla JAMI, Jiandang SHI, Zhanwen ZHOU, Changhao LIU

Dynamic thiol/disulfide homeostasis as oxidative stress marker in diabetic ketoacidosis

Özcan EREL, Fatih Ahmet KAHRAMAN, F. Güllü HAYDAR, Yavuz OTAL

Pain during walking and ascending stairs before hyaluronic acid injection was common in patients with knee osteoarthritis: a qualitative study

Şerife Şeyma TORĞUTALP, Feza KORKUSUZ, Gürhan DÖNMEZ, Naila BABAYEVA, https://orcid.org/0000-0002-0815-6494, Ömer Serkan KARA

Risk factors for evisceration in gynecological oncology surgeries

Taner TURAN, Caner ÇAKIR, Dilek YÜKSEL, Çiğdem KILIÇ, Mehmet ÜNSAL, Alper KARALÖK, Günsu KİMYON CÖMERT, Osman TÜRKMEN, Fatih KILIÇ

Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals

Büşra AKYOL, Güle ÇINAR, Büşra AKYOL, Alpay AZAP, İrem AKDEMİR KALKAN, Kemal Osman MEMİKOĞLU, Aysel PEHLİVANLI, Fatih ÜRKMEZ, İzel Ezgi TOPALOĞLU

Outcome of noncritical COVID-19 patients with early hospitalization and early antiviral treatment outside the ICU

Alpaslan ALP, Sevilay KARAHAN, Arzu TOPELİ, Gülay SAİN GÜVEN, Nursel ÇALIK BAŞARAN, Oğuz Abdullah UYAROĞLU, Lale ÖZIŞIK, Şerife Gül ÖZ, Taha Koray ŞAHİN, Serhat ÜNAL, Ahmet Çağkan İNKAYA, Ömrüm UZUN, Murat AKOVA, Gökhan METAN, Şehnaz ALP, Zahit TAŞ, Gülçin TELLİ DİZMAN, Pınar ZARAKOLU

Metformin promotes apoptosis in primary breast cancer cells by downregulation of cyclin D1 and upregulation of P53 through an AMPK-alpha independent mechanism

Kazım ŞENOL, Güven YENMİŞ, Fatma Sinem HOCAOĞLU EMRE, Elif YAPRAK SARAÇ, Nail Beşli, Gönül KANIGÜR SULTUYBEK

Interobserver and intermethod variability in data interpretation of breast strain elastography in suspicious breast lesions

Meriç YAVUZ ÇOLAK, Serdar ARSLAN, Hale TURNAOĞLU, Nihal USLU, Funda ULU ÖZTÜRK, Kemal Murat HABERAL