Eventos adversos a antibióticos em pacientes internados em um hospital universitário

Abstract

Adverse events to antibiotics in inpatients of a university hospital ABSTRACTOBJECTIVE: Antibiotics are the most common drugs causing adverse events and they lead to problems to patients and additional costs of the health system. The aim of the study was to evaluate the occurrence of adverse events to antibiotics in inpatients of a hospital. METHODS:An extensive drug monitoring was conducted in adult inpatients taking antibiotics in the city of Maringá, Southern Brazil, from September 2002 to February 2003. Variables related to medications used, especially those related to antibiotic use and adverse events, were studied. Based on criteria for adequate antibiotic use, the observed events were classifi ed as adverse events, medication errors and near-misses. For the analysis of causality between drug administration and event occurrence Naranjo algorithm was used. RESULTS:A total of 87 patients were studied and 91 adverse events were identifi ed: three (3.3%) adverse drug reactions; seven (7.7%) medication errors; and 81 (89.0%) medication near-misses. Adverse drug reactions were related to the use of quinolones and likely according to Naranjo algorithm. The seven medication errors were associated to four inadequately prescribed doses and three drug interactions. CONCLUSIONS:The study results indicate that an inadequate knowledge on antibiotics or lack of information about the patient at the time of prescription were the major factors involved in the occurrence of adverse events.

Prescription errors in Brazilian hospitals: a multi-centre exploratory survey

“…In this study, few prescriptions analyzed contained the correct and complete specifications, which are paramount for treatment success. These Table 2 Distribution of drug prescriptions in terms of changes made, date and timing, from December 2002 to January 2003. findings corroborate other previous studies and demonstrate the need to restructure the medication process to avoid omission of information in prescriptions 30,31 . The literature affirms that most hospitals do not have a computerized physician order entry system yet, and for this reason the incorporation of the pharmacist into the health care team is a more feasible alternative to checking prescription completeness to avoid these errors 14,30,31 .…”

“…The omission of this information may cause the interruption of drug administration before the foreseen treatment duration. In the case of antibiotics, for instance, the interruption before the foreseen treatment duration may cause bacterial resistance and the inability to use subsequently the same antimicrobial agent 30 .…”

Análise da administração de medicamentos intravenosos em hospital da rede sentinela

“…4 In Brazil, studies on adverse events, which included errors in prescription, storage and administration, have already improved, being of special interest a study on intensive monitoring of antimicrobials in a Paraná hospital, which identified the occurrence of 91 adverse events, being 3.3% adverse reactions to medication and 7.7% medication errors. 5 Meanwhile, in a university hospital in Ribeirão Preto, SP, 925 prescriptions were analyzed, with 21.1% presenting text erasures, and 28.2% presenting unclear information to the professionals. In another study, 7 conducted in a reference public hospital in Minas Gerais, there was an analysis of 4026 prescriptions with items containing potentially dangerous medication, which found 89.1% of problems belonging to four categories: absence of dosage and phamaceutical form, poor readability and doubtful dosage.…”

Erros na prescrição hospitalar de medicamentos potencialmente perigosos

“…2 A importância de problemas de decisão na prescrição foi observada em estudo sobre antibióticos realizado em hospital universitário brasileiro, tendo sido registrados 91 incidentes, dos quais 7,7% foram considerados erros de prescrição e de tipo de decisão. 16 Conforme Aspden et al 2 (2007), as recomendações com maior evidência científi ca para a prevenção de erros de medicação em hospitais são: adoção da prescrição eletrônica com o devido suporte clínico, inclusão de farmacêuticos nas visitas clínicas, viabilização de contato com farmacêuticos durante 24 horas para solucionar dúvidas em relação a medicamentos, e presença de procedimentos especiais e protocolos escritos para o uso de MPP. Esta última medida poderá prevenir parte considerável dos erros com medicamentos de alto risco.…”