Incidence and impact of adverse effects to antibiotics in hospitalized adults with pneumonia

Lin, Robert Y.; Nuruzzaman, Farzana; Shah, Shaili

doi:10.1002/jhm.414

Cited by 27 publications

(21 citation statements)

References 23 publications

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“…In addition to excess costs, these unnecessary antibiotic combinations increase the risk of adverse drug events. 30 Each agent has a risk of side effects, and combinations increase those risks as well as the risks for drug-drug interactions, such as the potential drug antagonism with vancomycin and linezolid. 31,32 Further, the combinations identified in this study were all intravenous agents that can pose unnecessary exposure to injectable medications and the risks that come with those exposures (eg, bloodstream infections).…”

Section: Discussionmentioning

confidence: 99%

Economic Impact of Redundant Antimicrobial Therapy in US Hospitals

Schultz

Lowe²,

Srinivasan

et al. 2014

Infect. Control Hosp. Epidemiol.

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Section: Discussionmentioning

confidence: 99%

Economic Impact of Redundant Antimicrobial Therapy in US Hospitals

Schultz

Lowe²,

Srinivasan

et al. 2014

Infect. Control Hosp. Epidemiol.

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“…The detection of antibiotic associated ADEs are essential for patient safety. Although numerous studies have been conducted in other countries except Pakistan to determine the preventability associated with ADEs and causal relation of ADRs with antibiotics but those were either limited to a single class of antibiotics or single infection of bacterial origin [ 24 – 27 ]. Therefore, the present study aims to determine the preventability and the reasons of ADEs along with the causal relationship of ADRs with antibiotics that are commonly administered to the hospitalized patients in Pakistan.…”

Section: Introductionmentioning

confidence: 99%

Causality and preventability assessment of adverse drug reactions and adverse drug events of antibiotics among hospitalized patients: A multicenter, cross-sectional study in Lahore, Pakistan

et al. 2018

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Background and objectivesAdverse drug events (ADEs) are the fifth leading cause of death and thus responsible for a large number of hospital admissions in all over the globe. This study was aimed to assess the antibiotics associated preventability of ADEs and causality of adverse drug reactions (ADRs) among hospitalized patients.MethodsA prospective, cross-sectional, observational study was conducted in four tertiary care public sector hospitals of Lahore, Pakistan. Study population consisted of hospitalized patients who were prescribed with one or more antibiotics. Data were collected between 1st January, 2017 and 31st June, 2017 from 1,249 patients (384 patients aged ≤ 18 years and 865 patients aged >18 years). Schumock and Thornton scale was used to assess the preventability of the ADEs. Medication errors (MEs) that caused preventable ADEs were assessed by MEs tracking form while Naranjo score was used to evaluate the causal relation of ADRs with the antibiotics. Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) and Microsoft Excel (MS Office, 2010) were used for data analysis.Results2,686 antibiotics were prescribed to 1,249 patients. Among them, fluoroquinolones (11.8%), macrolides (11.6%) and cephalosporins (10.9%) were the most frequently prescribed antibiotics. The most affected organ system by antibiotics associated ADEs was gastrointestinal tract. A total of 486 ADEs were found. The preventability assessment revealed that most of the ADEs (58.4%) were preventable (43.6% of the ADEs were definitely preventable while 14.8% were probably preventable) and caused by MEs including wrong drug (40.1%) and monitoring errors (25.0%), during the stage of physician ordering (22.2%) and patient monitoring (21.1%). The errors were caused due to non-adherence of policies (38.4%) and lack of information about antibiotics (32%). Most of the non-preventable ADEs or ADRs among adults and children were “probable” (35.5%) and “possible” (35.8%), respectively. Logistic regression analysis revealed that ADEs were significantly less among females (OR = 0.047, 95%CI = 0.018–0.121, p-value = <0.001), patients aged 18–52 years (OR = 0.041, 95%CI = 0.013–0.130, p-value = <0.001), tuberculosis patients (OR = 0.304, 95%CI = 0.186–0.497, p-value = <0.001), patients with acute respiratory tract infections (OR = 0.004, 95%CI = 0.01−0.019, p-value = <0.001) and among the patients prescribed with 2 antibiotics per prescription (OR = 0.455, 95%CI = 0.319–0.650, p-value = <0.001).ConclusionAccording to preventability assessment most of the ADEs were definitely preventable and caused by MEs due to non-adherence of policies and lack of information about antibiotics. The causality assessment of non-preventable ADEs showed that most of the ADRs were probable and possible.

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“…Each of the preceding studies addressing antibiotic-associated ADEs had several limitations. According to a previous study based on an administrative database, only 0.45% to 0.6% of patients hospitalized with pneumonia developed antibiotic-associated ADEs (4). However, the results were derived from registration data and therefore had undeniable under-reporting of existing ADEs.…”

Section: Discussionmentioning

confidence: 99%

“…To minimize antibiotic-associated ADEs, an estimation of their incidence is essential, but studies regarding the prevalence of antibiotic-associated ADEs in actual clinical practice have been insufficient. Previous studies were based on administrative databases alone and limited to a single infectious syndrome (4) or antibiotic class (5, 6). A comprehensive analysis of the ADE incidence among hospitalized patients was performed only recently in a study that was limited to a single facility (2).…”

Section: Introductionmentioning

confidence: 99%

Association of Adverse Drug Events with Broad-spectrum Antibiotic Use in Hospitalized Patients: A Single-center Study

et al. 2019

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Objective The importance of antimicrobial stewardship is increasingly highlighted in this age of antimicrobial resistance. A better comprehension of adverse drug events (ADEs) can promote the appropriate use of antibiotics. We aimed to quantify the incidence of ADEs associated with broad-spectrum systemic antibiotics in a hospital setting. Methods We conducted a six-month prospective, observational study at Osaka University Hospital to describe the incidence of ADEs in patients hospitalized in general wards undergoing treatment with broad-spectrum antibiotics [carbapenems, piperacillin/tazobactam (PIPC/TAZ), and anti-methicillin-resistant Staphylococcus aureus agents]. The occurrence of ADE was defined as any cardiac, gastrointestinal, hepatobiliary, renal, neurologic, hematologic, dermatologic, or musculoskeletal manifestation after 48 hours or more of systemic antibiotic therapy. Results The 3 most frequently prescribed antibiotics were PIPC/TAZ (242 cases), meropenem (181 cases), and vancomycin (92 cases). Of 689 patients, 118 (17.1%) experienced ADEs, including gastrointestinal (6.4%), hepatobiliary (4.2%), dermatologic (2.5%), and renal (2.3%) manifestations. Patients treated with PIPC/TAZ, meropenem, doripenem, vancomycin, daptomycin, and teicoplanin developed ADEs at rates of 20.7%, 16.0%, 15.4%, 19.6%, 11.8%, and 10.9%, respectively. Conclusion Our study provides a quantitative value for the incidence of ADEs associated with broad-spectrum antibiotics in clinical practice. To optimize patient safety, clinicians need to be aware of the risks associated with antibiotic administration.

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Incidence and impact of adverse effects to antibiotics in hospitalized adults with pneumonia

Cited by 27 publications

References 23 publications

Economic Impact of Redundant Antimicrobial Therapy in US Hospitals

Economic Impact of Redundant Antimicrobial Therapy in US Hospitals

Causality and preventability assessment of adverse drug reactions and adverse drug events of antibiotics among hospitalized patients: A multicenter, cross-sectional study in Lahore, Pakistan

Association of Adverse Drug Events with Broad-spectrum Antibiotic Use in Hospitalized Patients: A Single-center Study

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