Faculty of Pharmacy and Pharmaceutical Sciences, Department of Pharmaceutics, University of Karachi, Karachi, Pakistan.
Niazi College of Pharmacy, Niazi Medical and Dental College, Sargodha, Pakistan.
PLoS One. 2023 Oct 9;18(10):e0285171. doi: 10.1371/journal.pone.0285171. eCollection 2023.
Meningitis is an important cause of morbidity and mortality in children and adults. Its treatment strategy varies with age and gender. To assess potential drug-related problems (PDRP) and clinical outcomes in bacterial meningitis patients, a multicenter, clinical, descriptive, cross-sectional prospective observational study in 120 patients admitted to different tertiary care hospitals in Karachi was conducted. It includes both males 48% and females 52% belonging from all age groups i.e. peadiatrics (01 to 12 years), adults (18 to 65 years), and geriatrics (66 to 75 years). Out of these 72 patients were admitted in the public sector and 48 patients were admitted in private sector hospitals. Nosocomial infections were developed in 41% of patients during their stay at the hospital. Potentially nephrotoxic drugs were administered to all BM patients, these drugs should be administered carefully. Majorly Ceftriaxone was administered to 86% of patients, Vancomycin 71%, and meropenem 73% whereas 68% of patients were administered piperacillin-tazobactam. Organisms involved as causative agents in the majority of patients are Neisseria meningitides, Pseudomonas aeruginosa and, Streptococcus pneumoniae. DRPs impacted patient clinical outcomes in presence of many other factors like comorbidities, DDIs, Nis, administration of potentially nephrotoxic drugs, and administration of watch group and reserve group antibiotics without having culture sensitivity test, even after having CST no principles of de-escalation for antibiotics were done, which is a very important factor for hospitalized patients having IV antibiotics. The mortality rate among BM patients was 66%. The majority of patients (87%) stay at the hospital was 1-10 days. The present study helped in the identification of DRPs along with some other factors affecting the clinical outcomes in patients suffering from bacterial meningitis. Healthcare professionals should receive awareness and education on the importance of CST before initiating antibiotic therapy. Pharmacist-led medication review is necessary and should be followed to avoid negative outcomes and serious consequences related to DRPs.
脑膜炎是儿童和成人发病率和死亡率的重要原因。其治疗策略因年龄和性别而异。为了评估细菌性脑膜炎患者的潜在药物相关问题（PDRP）和临床结局，在卡拉奇的 12 家不同三级护理医院进行了一项多中心、临床、描述性、横断面前瞻性观察研究。研究对象包括 48%的男性和 52%的女性，年龄分布在儿科（01 至 12 岁）、成人（18 至 65 岁）和老年科（66 至 75 岁）。其中 72 名患者在公立医院住院，48 名患者在私立医院住院。41%的患者在住院期间发生医院获得性感染。所有 BM 患者均使用潜在肾毒性药物，这些药物应谨慎使用。主要给予 86%的患者头孢曲松，71%的患者万古霉素，73%的患者美罗培南，68%的患者给予哌拉西林他唑巴坦。大多数患者的病原体为脑膜炎奈瑟菌、铜绿假单胞菌和肺炎链球菌。在许多其他因素的影响下，如合并症、药物相互作用、院内感染、潜在肾毒性药物的使用、未进行培养敏感性试验就使用观察药物和储备药物，以及即使进行了 CST 也没有进行抗生素降阶梯治疗的原则，这些因素都对使用静脉抗生素的住院患者的临床结局产生影响。BM 患者的死亡率为 66%。大多数患者（87%）住院时间为 1-10 天。本研究有助于识别 DRP 以及影响细菌性脑膜炎患者临床结局的其他一些因素。在开始抗生素治疗之前，医护人员应提高对 CST 的认识和重视。药剂师主导的药物审查是必要的，应遵循该审查以避免与 DRP 相关的不良后果和严重后果。
