Prescribing practices of lopinavir/ritonavir, hydroxychloroquine and azithromycin during the COVID-19 epidemic crisis and pharmaceutical interventions in a French teaching hospital.


Journal

European journal of hospital pharmacy : science and practice
ISSN: 2047-9956
Titre abrégé: Eur J Hosp Pharm
Pays: England
ID NLM: 101578294

Informations de publication

Date de publication:
09 2021
Historique:
received: 09 07 2020
revised: 23 10 2020
accepted: 02 11 2020
pubmed: 27 11 2020
medline: 10 9 2021
entrez: 26 11 2020
Statut: ppublish

Résumé

The aims of this study were to describe prescribing practices of lopinavir/ritonavir, hydroxychloroquine and azithromycin during the COVID-19 epidemic crisis (primary endpoint), then to characterise pharmaceutical interventions (PIs) targeted to these medications and evaluate the impact of these PIs on prescribers' practices (secondary end-points). This retrospective observational study was carried out at the University Hospital of Strasbourg (France) from March to April 2020. The analysed population excluded patients from intensive care units but included all other adult patients with COVID-19 who received at least one dose of lopinavir/ritonavir combination, hydroxychloroquine or azithromycin, while inpatients. Analyses were performed by using data extracted from electronic medical records. During the study period, 278 patients were included. A rapid decrease in lopinavir/ritonavir prescriptions was observed. This was accompanied by an increase in hydroxychloroquine and azithromycin prescriptions until the end of March, followed by a decrease leading to the disappearance of these two medications in April. The pharmaceutical analysis of the prescriptions resulted in 59 PIs of which 21 were associated with lopinavir/ritonavir, 32 with hydroxychloroquine and 6 with azithromycin. Regarding the medication-related problems, the most frequent ones were incorrect treatment durations (n=32 (54.2%)), drug interactions with potential torsadogenic reactions (n=14 (23.7%)) and incorrect dosing (n=6 (10.2%)). From the 59 PIs, 48 (81.4%) were accepted and physicians adjusted the medication regimens in a timely manner. This study demonstrated the value-even more meaningful in a crisis situation-of a strong synergy between physicians and pharmacists for patient-safety focused practices.

Identifiants

pubmed: 33239282
pii: ejhpharm-2020-002449
doi: 10.1136/ejhpharm-2020-002449
pmc: PMC7689541
doi:

Substances chimiques

Antiviral Agents 0
Drug Combinations 0
lopinavir-ritonavir drug combination 0
Lopinavir 2494G1JF75
Hydroxychloroquine 4QWG6N8QKH
Azithromycin 83905-01-5
Ritonavir O3J8G9O825

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

242-247

Informations de copyright

© European Association of Hospital Pharmacists 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Benedicte Gourieux (B)

Pharmacy, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France.

Fanny Reisz (F)

Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France.

Anne Sophie Belmas (AS)

Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France.

François Danion (F)

Service des Maladies infectieuses et tropicales, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France.

Marion Fourtage (M)

Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France.

Thierry Nai (T)

Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France.

Aurélie Reiter-Schatz (A)

Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France.

Yvon Ruch (Y)

Service des Maladies infectieuses et tropicales, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France.

Julia Walther (J)

Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France.

Yasmine Nivoix (Y)

Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France.

Bruno Michel (B)

Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France bruno.michel@chru-strasbourg.fr.

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Classifications MeSH