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Sandes V, Figueras A, Lima EC. Pharmacovigilance Strategies to Address Resistance to Antibiotics and Inappropriate Use-A Narrative Review. Antibiotics (Basel) 2024; 13:457. [PMID: 38786184 PMCID: PMC11117530 DOI: 10.3390/antibiotics13050457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/11/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
The spread of antimicrobial resistance (AMR) is a global challenge. Close and continuous surveillance for quick detection of AMR can be difficult, especially in remote places. This narrative review focuses on the contributions of pharmacovigilance (PV) as an auxiliary tool for identifying and monitoring the ineffectiveness, resistance, and inappropriate use of antibiotics (ABs). The terms "drug ineffective", "therapeutic failure", "drug resistance", "pathogen resistance", and "multidrug resistance" were found in PV databases and dictionaries, denoting ineffectiveness. These terms cover a range of problems that should be better investigated because they are useful in warning about possible causes of AMR. "Medication errors", especially those related to dose and indication, and "Off-label use" are highlighted in the literature, suggesting inappropriate use of ABs. Hence, the included studies show that the terms of interest related to AMR and use are not only present but frequent in PV surveillance programs. This review illustrates the feasibility of using PV as a complementary tool for antimicrobial stewardship activities, especially in scenarios where other resources are scarce.
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Affiliation(s)
- Valcieny Sandes
- Postgraduate Program in Pharmaceutical Sciences, School of Pharmacy, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho-373, Rio de Janeiro 21941-170, RJ, Brazil;
- National Cancer Institute, Pr. da Cruz Vermelha-23, Rio de Janeiro 20230-130, RJ, Brazil
| | | | - Elisangela Costa Lima
- Postgraduate Program in Pharmaceutical Sciences, School of Pharmacy, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho-373, Rio de Janeiro 21941-170, RJ, Brazil;
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Demotier S, Limelette A, Charmillon A, Baux E, Parent X, Mestrallet S, Pavel S, Servettaz A, Dramé M, Muggeo A, Wynckel A, Gozalo C, Taam MA, Fillion A, Jaussaud R, Trenque T, Piroth L, Bani-Sadr F, Hentzien M. Incidence, associated factors, and effect on renal function of amoxicillin crystalluria in patients receiving high doses of intravenous amoxicillin (The CRISTAMOX Study): A cohort study. EClinicalMedicine 2022; 45:101340. [PMID: 35295665 PMCID: PMC8919213 DOI: 10.1016/j.eclinm.2022.101340] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Amoxicillin crystalluria (AC), potentially responsible for acute kidney injury (AKI), is reported more and more frequently in patients treated with high doses of intravenous amoxicillin (HDIVA). The main objective of this study was to evaluate AC incidence in these patients. The secondary objectives were to identify factors associated with AC and to evaluate its impact on the risk of AKI. METHODS This multicentre, observational, cohort study was conducted between Mar 18, 2014 and Aug 16, 2019 in Dijon, Nancy, and Reims University Hospitals as well as Châlon-sur-Saône, Charleville-Mézières, and Troyes general hospitals in France. Adult patients (≥18 years) treated with HDIVA and having been tested for AC at least once during treatment were included. Clinical, biological, and therapeutic characteristics of the patients were collected. A univariable mixed logistic regression model assessed the factors associated with AC. A multivariable Cox model with AC as a time-dependent variable assessed the prognostic factors for AKI. ClinicalTrials.gov number: NCT02853292. FINDINGS Of the 112 included patients, 27 (24.1%, 95% CI [16.2-32.0]) developed at least one episode of AC within a mean of 5.1 days. The factors associated with its occurrence were the concomitant use of angiotensin converting enzyme (ACE) inhibitors (OR=4.6, 95% CI [2.2-9.3], p<0.0001) and the decrease of urinary pH (OR=2.1 for one pH point decrease, 95% CI [1.2-3.7], p=0.009). 20 patients (17.9%) presented with AKI, within a mean time of 10.9 days. The main factor associated with the occurrence of AKI was the occurrence of AC (aHR=7.4, 95% CI [2.5-22.2], p=0.0003). INTERPRETATION AC occurred in a quarter of patients treated with HDIVA and was highly prognostic of AKI. FUNDING None.
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Affiliation(s)
- Sophie Demotier
- Service de Médecine Interne— Maladies infectieuses, Immunologie Clinique. Centre Hospitalier Universitaire Robert Debré, Reims, France
| | - Anne Limelette
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire Robert Debré, Reims, France
| | - Alexandre Charmillon
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire Brabois, Vandoeuvre-lès-Nancy, France
| | - Elisabeth Baux
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire Brabois, Vandoeuvre-lès-Nancy, France
| | - Xavier Parent
- Laboratoire de Biochimie, Hôpitaux Civils de Colmar, Colmar, France
| | - Stéphanie Mestrallet
- Service de Médecine Interne et Maladies Infectieuses, Centre Hospitalier Intercommunal Nord-Ardennes, Charleville-Mézières, France
| | - Simona Pavel
- Service de Médecine Interne et Maladies Infectieuses, Centre Hospitalier, Troyes, France
| | - Amélie Servettaz
- Service de Médecine Interne— Maladies infectieuses, Immunologie Clinique. Centre Hospitalier Universitaire Robert Debré, Reims, France
| | - Moustapha Dramé
- Département de Recherche Clinique et Innovation, Centre Hospitalier Universitaire Pierre Zobda-Quitman, Fort-de-France, France
| | - Anaelle Muggeo
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire Robert Debré, Reims, France
| | - Alain Wynckel
- Service de Néphrologie, Centre Hospitalier Universitaire Robert Debré, Reims, France
| | - Claire Gozalo
- Laboratoire de Pharmacologie-Toxicologie, Centre Hospitalier Universitaire Robert Debré, Reims, France
| | - Malak Abou Taam
- Pôle antalgie, anesthésie, rhumatologie, médicaments des addictions, Direction Médicale Médicament 2, ANSM, Saint-Denis, France
| | - Aurélie Fillion
- Service de Maladies Infectieuses, Centre Hospitalier William Morey, Chalon-sur-Saône, France
| | - Roland Jaussaud
- Service de Médecine Interne et Immunologie Clinique, Centre Hospitalier Universitaire Brabois, Vandoeuvre-lès-Nancy, France
| | - Thierry Trenque
- Centre Régional de Pharmacovigilance et de Pharmacoépidémiologie, Centre Hospitalier Universitaire Robert Debré, Reims, France
| | - Lionel Piroth
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire François Mitterand, Dijon, France
| | - Firouze Bani-Sadr
- Service de Médecine Interne— Maladies infectieuses, Immunologie Clinique. Centre Hospitalier Universitaire Robert Debré, Reims, France
| | - Maxime Hentzien
- Service de Médecine Interne— Maladies infectieuses, Immunologie Clinique. Centre Hospitalier Universitaire Robert Debré, Reims, France
- Corresponding author: Dr Maxime Hentzien, Service de Médecine Interne—Maladies infectieuses, Immunologie Clinique, Centre Hospitalier Universitaire Robert Debré, Avenue du général Koenig, 51092 Reims Cedex, France, Phone number: 0033 3 26 78 71 89 or 0033 6 07 85 01 77, Fax number: 0033 3 26 78 40 90
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