Vlak Iva, Samardžić Ivana, Marinović Ivana, Bušić Nikolina, Vrca Vesna Bačić
Department of Clinical Pharmacy, University Hospital Dubrava, 10000 Zagreb, Croatia.
Department of Hospital Infections and Antimicrobial Stewardship, University Hospital Dubrava, 10000 Zagreb, Croatia.
Pharmacy (Basel). 2023 Apr 2;11(2):68. doi: 10.3390/pharmacy11020068.
Antimicrobial consumption is increasing. In order to maximize the effectiveness of antimicrobial stewardship and provide safe and optimal use of restricted antimicrobial drugs, renal dosing should be evaluated. The aim of this study was to determine the prevalence of restricted antimicrobial drugs that required dose adjustment according to renal function. A retrospective, consecutive study was conducted at University Hospital Dubrava. This study analyzed requests for restricted antimicrobial drugs (n = 2890) during a 3-month period. Requests for antimicrobial agents were evaluated by the antimicrobial therapy management team (A-team). This study included 412 restricted antimicrobial drug requests requiring dose adjustment, of which 39.1% did not have an adjusted dose. Meropenem, Ciprofloxacin, Piperacillin/Tazobactam, Vancomycin, Colistin and the antimycotic Fluconazole were the most frequent restricted antimicrobial drugs that required dose adjustment according to impaired renal function. The results of this research highlight the importance of the A-team in the optimization of restricted antimicrobial therapy. Non-adjusted doses of restricted antimicrobial drugs increase the possibility of adverse drug reactions and therefore jeopardize pharmacotherapy outcomes and patient safety.
抗菌药物的消耗量正在增加。为了使抗菌药物管理的效果最大化，并确保安全且优化地使用受限抗菌药物，应评估肾脏给药剂量。本研究的目的是确定需要根据肾功能调整剂量的受限抗菌药物的流行情况。在杜布拉瓦大学医院进行了一项回顾性的连续研究。本研究分析了为期3个月的受限抗菌药物申请（n = 2890）。抗菌药物申请由抗菌治疗管理团队（A组）进行评估。本研究纳入了412份需要调整剂量的受限抗菌药物申请，其中39.1%没有调整后的剂量。美罗培南、环丙沙星、哌拉西林/他唑巴坦、万古霉素、黏菌素和抗真菌药氟康唑是最常需要根据肾功能受损情况调整剂量的受限抗菌药物。本研究结果凸显了A组在优化受限抗菌治疗方面的重要性。受限抗菌药物未调整剂量会增加药物不良反应的可能性，从而危及药物治疗效果和患者安全。
