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

AKYOL, Büşra; TOPALOĞLU, İZEL EZGİ; CINAR, GULE; Azap, Alpay; Akdemir Kalkan, İrem; MEMIKOGLU, KEMAL OSMAN; Pehlivanlı, Aysel; urkmez, fatih

doi:10.3906/sag-2004-164

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

İrem AKDEMİR KALKAN, (Ankara Üniversitesi, Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Ankara, Türkiye)

Güle ÇINAR, (Ankara Üniversitesi, Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Ankara, Türkiye)

Aysel PEHLİVANLI, (Ankara Üniversitesi, Eczacılık Fakültesi, Farmakoloji Anabilim Dalı, Ankara, Türkiye)

Fatih ÜRKMEZ, (Ankara Üniversitesi, Eczacılık Fakültesi, Farmakoloji Anabilim Dalı, Ankara, Türkiye)

İzel Ezgi TOPALOĞLU, (Ankara Üniversitesi, Eczacılık Fakültesi, Farmakoloji Anabilim Dalı, Ankara, Türkiye)

Büşra AKYOL, (Ankara Üniversitesi, Eczacılık Fakültesi, Farmakoloji Anabilim Dalı, Ankara, Türkiye)

Alpay AZAP, (Ankara Üniversitesi, Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Ankara, Türkiye)

Kemal Osman MEMİKOĞLU (Ankara Üniversitesi, Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Ankara, Türkiye)

Turkish Journal of Medical Sciences

4 1

Yıl: 2021 Cilt: 51 Sayı: 2 Sayfa Aralığı: 523 - 529 Metin Dili: İngilizce DOI: 10.3906/sag-2004-164 İndeks Tarihi: 21-01-2022

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

Öz:

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

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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

APA	Akdemir Kalkan İ, CINAR G, Pehlivanlı A, urkmez f, TOPALOĞLU İ, AKYOL B, Azap A, MEMIKOGLU K (2021). Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals. , 523 - 529. 10.3906/sag-2004-164
Chicago	Akdemir Kalkan İrem,CINAR GULE,Pehlivanlı Aysel,urkmez fatih,TOPALOĞLU İZEL EZGİ,AKYOL Büşra,Azap Alpay,MEMIKOGLU KEMAL OSMAN Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals. (2021): 523 - 529. 10.3906/sag-2004-164
MLA	Akdemir Kalkan İrem,CINAR GULE,Pehlivanlı Aysel,urkmez fatih,TOPALOĞLU İZEL EZGİ,AKYOL Büşra,Azap Alpay,MEMIKOGLU KEMAL OSMAN Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals. , 2021, ss.523 - 529. 10.3906/sag-2004-164
AMA	Akdemir Kalkan İ,CINAR G,Pehlivanlı A,urkmez f,TOPALOĞLU İ,AKYOL B,Azap A,MEMIKOGLU K Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals. . 2021; 523 - 529. 10.3906/sag-2004-164
Vancouver	Akdemir Kalkan İ,CINAR G,Pehlivanlı A,urkmez f,TOPALOĞLU İ,AKYOL B,Azap A,MEMIKOGLU K Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals. . 2021; 523 - 529. 10.3906/sag-2004-164
IEEE	Akdemir Kalkan İ,CINAR G,Pehlivanlı A,urkmez f,TOPALOĞLU İ,AKYOL B,Azap A,MEMIKOGLU K "Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals." , ss.523 - 529, 2021. 10.3906/sag-2004-164
ISNAD	Akdemir Kalkan, İrem vd. "Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals". (2021), 523-529. https://doi.org/10.3906/sag-2004-164

APA	Akdemir Kalkan İ, CINAR G, Pehlivanlı A, urkmez f, TOPALOĞLU İ, AKYOL B, Azap A, MEMIKOGLU K (2021). Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals. Turkish Journal of Medical Sciences, 51(2), 523 - 529. 10.3906/sag-2004-164
Chicago	Akdemir Kalkan İrem,CINAR GULE,Pehlivanlı Aysel,urkmez fatih,TOPALOĞLU İZEL EZGİ,AKYOL Büşra,Azap Alpay,MEMIKOGLU KEMAL OSMAN Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals. Turkish Journal of Medical Sciences 51, no.2 (2021): 523 - 529. 10.3906/sag-2004-164
MLA	Akdemir Kalkan İrem,CINAR GULE,Pehlivanlı Aysel,urkmez fatih,TOPALOĞLU İZEL EZGİ,AKYOL Büşra,Azap Alpay,MEMIKOGLU KEMAL OSMAN Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals. Turkish Journal of Medical Sciences, vol.51, no.2, 2021, ss.523 - 529. 10.3906/sag-2004-164
AMA	Akdemir Kalkan İ,CINAR G,Pehlivanlı A,urkmez f,TOPALOĞLU İ,AKYOL B,Azap A,MEMIKOGLU K Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals. Turkish Journal of Medical Sciences. 2021; 51(2): 523 - 529. 10.3906/sag-2004-164
Vancouver	Akdemir Kalkan İ,CINAR G,Pehlivanlı A,urkmez f,TOPALOĞLU İ,AKYOL B,Azap A,MEMIKOGLU K Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals. Turkish Journal of Medical Sciences. 2021; 51(2): 523 - 529. 10.3906/sag-2004-164
IEEE	Akdemir Kalkan İ,CINAR G,Pehlivanlı A,urkmez f,TOPALOĞLU İ,AKYOL B,Azap A,MEMIKOGLU K "Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals." Turkish Journal of Medical Sciences, 51, ss.523 - 529, 2021. 10.3906/sag-2004-164
ISNAD	Akdemir Kalkan, İrem vd. "Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals". Turkish Journal of Medical Sciences 51/2 (2021), 523-529. https://doi.org/10.3906/sag-2004-164