1
|
Shu L, Huo B, Yin N, Xie H, Erbu A, Ai M, Jia Y, Song L. Clinical drug interactions between linezolid and other antibiotics: For adverse drug event monitoring. Pharmacol Res Perspect 2024; 12:e1236. [PMID: 39049495 PMCID: PMC11269369 DOI: 10.1002/prp2.1236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/20/2024] [Accepted: 02/27/2024] [Indexed: 07/27/2024] Open
Abstract
Detailed data on safety associated with drug-drug interactions (DDIs) between Linezolid (LZD) and other antibiotics are limited. The aim of this study was to investigate the safety signals related to these DDIs and to provide a reference for clinically related adverse drug event monitoring. Adverse event (AE) information from 1 January 2004 to 16 June 2022 of the target antibiotics including LZD using alone or in combination with LZD was extracted from the OpenVigil FDA data platform for safety signal analysis. The combined risk ratio model, reporting ratio method, Ω shrinkage measure model, and chi-square statistics model were used to analyze the safety signals related to DDIs. Meanwhile, we evaluated the correlation and the influence of sex and age between the drug(s) and the target AE detected. There were 18991 AEs related to LZD. There were 2293, 1726, 4449, 821, 2431, 1053, and 463 AE reports when LZD was combined with amikacin, voriconazole, meropenem, clarithromycin, levofloxacin, piperacillin-tazobactam, and azithromycin, respectively. Except for azithromycin, there were positive safety signals related to DDIs between LZD and these antibiotics. These DDIs might influence the incidence of 13, 16, 7, 7, 6, and 15 types of AEs, respectively, and is associated with higher reporting rates of AEs compared with use alone. Moreover, sex and age might influence the occurrence of AEs. We found that the combinations of LZD and other antibiotics are related to multiple AEs, such as hepatotoxicity, drug resistance and electrocardiogram QT prolonged, but further research is still required to investigate their underlying mechanisms. This study can provide a new reference for the safety monitoring of LZD combined with other antibiotics in clinical practice.
Collapse
Affiliation(s)
- Ling Shu
- Department of PharmacyChildren's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing Key Laboratory of PediatricsChongqingChina
| | - Ben‐nian Huo
- Department of PharmacyChildren's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing Key Laboratory of PediatricsChongqingChina
| | - Nan‐ge Yin
- Department of PharmacyChildren's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing Key Laboratory of PediatricsChongqingChina
| | | | - Aga Erbu
- Medicine College of Tibet UniversityLhasaChina
| | - Mao‐lin Ai
- Department of PharmacyChildren's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing Key Laboratory of PediatricsChongqingChina
| | - Yun‐tao Jia
- Department of PharmacyChildren's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing Key Laboratory of PediatricsChongqingChina
| | - Lin Song
- Department of PharmacyChildren's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing Key Laboratory of PediatricsChongqingChina
| |
Collapse
|
2
|
Torrent Rodríguez A, Font I Barceló A, Barrantes González M, Echeverria Esnal D, Soy Muner D, Martínez JA, Tuset Creus M. Clinically important pharmacokinetic drug-drug interactions with antibacterial agents. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2024; 37:299-322. [PMID: 38840420 PMCID: PMC11231487 DOI: 10.37201/req/037.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Antimicrobial agents are widely used, and drug interactions are challenging due to increased risk of adverse effects or reduced efficacy. Among the interactions, the most important are those affecting metabolism, although those involving drug transporters are becoming increasingly known. To make clinical decisions, it is key to know the intensity of the interaction, as well as its duration and time-dependent recovery after discontinuation of the causative agents. It is not only important to be aware of all patient treatments, but also of supplements and natural medications that may also interact. Although they can have serious consequences, most interactions can be adequately managed with a good understanding of them. Especially in patients with polipharmacy it is compulsory to check them with an electronic clinical decision support database. This article aims to conduct a narrative review focusing on the major clinically significant pharmacokinetic drug-drug interactions that can be seen in patients receiving treatment for bacterial infections.
Collapse
Affiliation(s)
- A Torrent Rodríguez
- Arnau Torrent-Rodríguez,Hospital Clínic de Barcelona, Carrer Villarroel 170, 08036, Barcelona, Cataluña, Spain.
| | | | | | | | | | | | | |
Collapse
|
3
|
Albayrak A, Akkuzu E, Karahalil B. The impact of antimicrobial use on potential major drug-drug interactions in the pediatric Intensive Care Unit patients at University Hospital in Türkiye. Minerva Pediatr (Torino) 2024; 76:388-394. [PMID: 33858128 DOI: 10.23736/s2724-5276.21.06173-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Antimicrobials, especially antibiotics, are among the most widely used drugs in the pediatric intensive care unit. Pediatrics patients in intensive care unit are exposed to potential drug-drug interactions (PDDIs) and suffered from their adverse and side effects. The aim of this study is to evaluate the impact of antimicrobial use on PDDIs, as well as to examine the rate and the risk factors PDDIs, furthermore the management of PDDIs. METHODS The present retrospective cohort study included 179 patients under 18 years of age who were hospitalized in Pediatric Intensive Care Unit in Türkiye. Drug interactions were evaluated using the Lexicomp® (Macedonia, OH, USA) drug interaction tool which provides evidence-based drug information. RESULTS Our study results showed that the frequency of the use of antimicrobial drugs (antibiotic, antifungal, antiviral) was found to be statistically significantly higher (P<0.05) in the group with PDDIs compared to the group without PDDIs. Especially, the use of carbapenem, cephalosporin among the antibiotic groups significantly increased the frequency of PDDIs (P<0.05). While the probability PDDIs statistically significantly increased 3.73 times (OR [odds ratio] = 3.73; 95% CI=1.47-9.50) in patients who used a single antibiotic compared to patients who did not use antibiotics (P=0.006), the probability of the occurrence of PDDIs by using more than one antibiotic was statistically significantly 8.5 times (95% CI=3.30-21.89) (P<0.001). CONCLUSIONS Our study results showed that the use of antimicrobial drugs (antibiotic, antifungal, antiviral) was found to be statistically significantly higher (P<0.05) in the group with PDDIs.
Collapse
Affiliation(s)
- Aslınur Albayrak
- Department of Clinical Pharmacy, Faculty of Pharmacy, Gazi University, Ankara, Türkiye -
| | - Emine Akkuzu
- Department of Pediatric Intensive Care, Medical Faculty, Gazi University, Ankara, Türkiye
| | - Bensu Karahalil
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Gazi University, Ankara, Türkiye
| |
Collapse
|
4
|
Periferakis A, Periferakis AT, Troumpata L, Dragosloveanu S, Timofticiuc IA, Georgatos-Garcia S, Scheau AE, Periferakis K, Caruntu A, Badarau IA, Scheau C, Caruntu C. Use of Biomaterials in 3D Printing as a Solution to Microbial Infections in Arthroplasty and Osseous Reconstruction. Biomimetics (Basel) 2024; 9:154. [PMID: 38534839 DOI: 10.3390/biomimetics9030154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/28/2024] Open
Abstract
The incidence of microbial infections in orthopedic prosthetic surgeries is a perennial problem that increases morbidity and mortality, representing one of the major complications of such medical interventions. The emergence of novel technologies, especially 3D printing, represents a promising avenue of development for reducing the risk of such eventualities. There are already a host of biomaterials, suitable for 3D printing, that are being tested for antimicrobial properties when they are coated with bioactive compounds, such as antibiotics, or combined with hydrogels with antimicrobial and antioxidant properties, such as chitosan and metal nanoparticles, among others. The materials discussed in the context of this paper comprise beta-tricalcium phosphate (β-TCP), biphasic calcium phosphate (BCP), hydroxyapatite, lithium disilicate glass, polyetheretherketone (PEEK), poly(propylene fumarate) (PPF), poly(trimethylene carbonate) (PTMC), and zirconia. While the recent research results are promising, further development is required to address the increasing antibiotic resistance exhibited by several common pathogens, the potential for fungal infections, and the potential toxicity of some metal nanoparticles. Other solutions, like the incorporation of phytochemicals, should also be explored. Incorporating artificial intelligence (AI) in the development of certain orthopedic implants and the potential use of AI against bacterial infections might represent viable solutions to these problems. Finally, there are some legal considerations associated with the use of biomaterials and the widespread use of 3D printing, which must be taken into account.
Collapse
Affiliation(s)
- Argyrios Periferakis
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Akadimia of Ancient Greek and Traditional Chinese Medicine, 16675 Athens, Greece
- Elkyda, Research & Education Centre of Charismatheia, 17675 Athens, Greece
| | - Aristodemos-Theodoros Periferakis
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Elkyda, Research & Education Centre of Charismatheia, 17675 Athens, Greece
| | - Lamprini Troumpata
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Serban Dragosloveanu
- Department of Orthopaedics and Traumatology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Orthopaedics, "Foisor" Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Iosif-Aliodor Timofticiuc
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Spyrangelos Georgatos-Garcia
- Tilburg Institute for Law, Technology, and Society (TILT), Tilburg University, 5037 DE Tilburg, The Netherlands
- Corvers Greece IKE, 15124 Athens, Greece
| | - Andreea-Elena Scheau
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Konstantinos Periferakis
- Akadimia of Ancient Greek and Traditional Chinese Medicine, 16675 Athens, Greece
- Pan-Hellenic Organization of Educational Programs (P.O.E.P.), 17236 Athens, Greece
| | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, "Carol Davila" Central Military Emergency Hospital, 010825 Bucharest, Romania
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Ioana Anca Badarau
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristian Scheau
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Radiology and Medical Imaging, "Foisor" Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, "Prof. N.C. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| |
Collapse
|
5
|
Vocca C, Siniscalchi A, Rania V, Galati C, Marcianò G, Palleria C, Catarisano L, Gareri I, Leuzzi M, Muraca L, Citraro R, Nanci G, Scuteri A, Bianco RC, Fera I, Greco A, Leuzzi G, De Sarro G, D’Agostino B, Gallelli L. The Risk of Drug Interactions in Older Primary Care Patients after Hospital Discharge: The Role of Drug Reconciliation. Geriatrics (Basel) 2023; 8:122. [PMID: 38132493 PMCID: PMC10742527 DOI: 10.3390/geriatrics8060122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/08/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION Drug-drug interactions (DDIs) represent an important clinical problem, particularly in older patients, due to polytherapy, comorbidity, and physiological changes in pharmacodynamic and pharmacokinetic pathways. In this study, we investigated the association between drugs prescribed after discharge from the hospital or clinic and the risk of DDIs with drugs used daily by each patient. METHODS We performed an observational, retrospective, multicenter study on the medical records of outpatients referred to general practitioners. DDIs were measured using the drug interaction probability scale. Potential drug interactions were evaluated by clinical pharmacologists (physicians) and neurologists. Collected data were analyzed using the Statistical Package for the Social Sciences. RESULTS During the study, we evaluated 1772 medical records. We recorded the development of DDIs in 10.3% of patients; 11.6% of these patients required hospitalization. Logistic regression showed an association among DDIs, sex, and the number of drugs used (p = 0.023). CONCLUSIONS This observational real-life study shows that the risk of DDIs is common in older patients. Physicians must pay more attention after hospital discharge, evaluating the treatment to reduce the risk of DDIs.
Collapse
Affiliation(s)
- Cristina Vocca
- Operative Unit of Clinical Pharmacology and Pharmacovigilance, Renato Dulbecco University Hospital, 88100 Catanzaro, Italy; (C.V.); (V.R.); (G.M.); (C.P.); (L.C.); (I.G.); (G.D.S.)
| | - Antonio Siniscalchi
- Department of Neurology and Stroke Unit, Annunziata Hospital of Cosenza, 87100 Cosenza, Italy;
| | - Vincenzo Rania
- Operative Unit of Clinical Pharmacology and Pharmacovigilance, Renato Dulbecco University Hospital, 88100 Catanzaro, Italy; (C.V.); (V.R.); (G.M.); (C.P.); (L.C.); (I.G.); (G.D.S.)
| | - Cecilia Galati
- Research Center FAS@UMG, Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy;
| | - Gianmarco Marcianò
- Operative Unit of Clinical Pharmacology and Pharmacovigilance, Renato Dulbecco University Hospital, 88100 Catanzaro, Italy; (C.V.); (V.R.); (G.M.); (C.P.); (L.C.); (I.G.); (G.D.S.)
| | - Caterina Palleria
- Operative Unit of Clinical Pharmacology and Pharmacovigilance, Renato Dulbecco University Hospital, 88100 Catanzaro, Italy; (C.V.); (V.R.); (G.M.); (C.P.); (L.C.); (I.G.); (G.D.S.)
- Research Center FAS@UMG, Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy;
| | - Luca Catarisano
- Operative Unit of Clinical Pharmacology and Pharmacovigilance, Renato Dulbecco University Hospital, 88100 Catanzaro, Italy; (C.V.); (V.R.); (G.M.); (C.P.); (L.C.); (I.G.); (G.D.S.)
| | - Ilaria Gareri
- Operative Unit of Clinical Pharmacology and Pharmacovigilance, Renato Dulbecco University Hospital, 88100 Catanzaro, Italy; (C.V.); (V.R.); (G.M.); (C.P.); (L.C.); (I.G.); (G.D.S.)
| | - Marco Leuzzi
- Department of Primary Care, ASP Catanzaro, 88100 Catanzaro, Italy; (M.L.); (L.M.); (G.N.); (A.S.); (R.C.B.); (I.F.); (A.G.); (G.L.)
| | - Lucia Muraca
- Department of Primary Care, ASP Catanzaro, 88100 Catanzaro, Italy; (M.L.); (L.M.); (G.N.); (A.S.); (R.C.B.); (I.F.); (A.G.); (G.L.)
| | - Rita Citraro
- Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy;
| | - Giacinto Nanci
- Department of Primary Care, ASP Catanzaro, 88100 Catanzaro, Italy; (M.L.); (L.M.); (G.N.); (A.S.); (R.C.B.); (I.F.); (A.G.); (G.L.)
| | - Antonio Scuteri
- Department of Primary Care, ASP Catanzaro, 88100 Catanzaro, Italy; (M.L.); (L.M.); (G.N.); (A.S.); (R.C.B.); (I.F.); (A.G.); (G.L.)
| | - Rosa Candida Bianco
- Department of Primary Care, ASP Catanzaro, 88100 Catanzaro, Italy; (M.L.); (L.M.); (G.N.); (A.S.); (R.C.B.); (I.F.); (A.G.); (G.L.)
| | - Iolanda Fera
- Department of Primary Care, ASP Catanzaro, 88100 Catanzaro, Italy; (M.L.); (L.M.); (G.N.); (A.S.); (R.C.B.); (I.F.); (A.G.); (G.L.)
| | - Antonietta Greco
- Department of Primary Care, ASP Catanzaro, 88100 Catanzaro, Italy; (M.L.); (L.M.); (G.N.); (A.S.); (R.C.B.); (I.F.); (A.G.); (G.L.)
| | - Giacomo Leuzzi
- Department of Primary Care, ASP Catanzaro, 88100 Catanzaro, Italy; (M.L.); (L.M.); (G.N.); (A.S.); (R.C.B.); (I.F.); (A.G.); (G.L.)
| | - Giovambattista De Sarro
- Operative Unit of Clinical Pharmacology and Pharmacovigilance, Renato Dulbecco University Hospital, 88100 Catanzaro, Italy; (C.V.); (V.R.); (G.M.); (C.P.); (L.C.); (I.G.); (G.D.S.)
- Research Center FAS@UMG, Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy;
- Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy;
| | - Bruno D’Agostino
- Department of Environmental Biological and Pharmaceutical Sciences and Technologies, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy;
| | - Luca Gallelli
- Operative Unit of Clinical Pharmacology and Pharmacovigilance, Renato Dulbecco University Hospital, 88100 Catanzaro, Italy; (C.V.); (V.R.); (G.M.); (C.P.); (L.C.); (I.G.); (G.D.S.)
- Research Center FAS@UMG, Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy;
- Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy;
- Medifarmagen SRL, Renato Dulbecco University Hospital, 88100 Catanzaro, Italy
| |
Collapse
|
6
|
Shah N, Mustafa SS, Vinh DC. Management of secondary immunodeficiency in hematological malignancies in the era of modern oncology. Crit Rev Oncol Hematol 2023; 181:103896. [PMID: 36528276 DOI: 10.1016/j.critrevonc.2022.103896] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 11/29/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
Secondary immunodeficiency (SID) in patients with B-cell hematological malignancies is a common condition that presents with recurrent infection. SID is due to both the inherent immune defects due to the malignancy, as well as secondary to cancer therapies, many of which have B-cell depleting properties. The early diagnosis of SID and the optimization of intervention strategies are key to delivering the most effective cancer treatments and reducing infection-related morbidity and mortality. This review discusses current practice, recommendations, and challenges for SID diagnosis, based on the evaluation of clinical history and laboratory assessments, and the effectiveness of specific vaccines and immunoglobulin replacement therapy in reducing the frequency and recurrence of infections in patients with SID, and the healthcare system-associated costs.
Collapse
Affiliation(s)
- Nina Shah
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States.
| | - S Shahzad Mustafa
- Rochester Regional Health, Rochester, NY, United States; Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Donald C Vinh
- Department of Medicine, McGill University Health Centre, Montreal, Canada
| |
Collapse
|
7
|
Barros DP, Onofre PSDC, Fonseca FLA, Rosa PCP, Pedreira MDLG, Peterlini MAS. Stability of vancomycin hydrochloride employed in antimicrobial seal solutions of central intravenous catheters. Rev Lat Am Enfermagem 2022; 30:e3620. [PMID: 35920542 DOI: 10.1590/1518-8345.5869.3620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/28/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to verify the stability of vancomycin hydrochloride in antimicrobial seal solutions with and without association of heparin sodium according to temperature and association time. METHOD an experimental study designed for the analysis of hydrogenionic potential and concentration by means of high-efficiency liquid chromatography of vancomycin hydrochloride (n=06) and vancomycin hydrochloride and heparin sodium (n=06). The solutions studied were submitted to absence of light, as well as to 22°C and 37°C. Analyses in triplicate (n=192) were performed at the initial moment (T0) and three (T3), eight (T8) and 24 hours (T24) after preparation. The data were submitted to analysis of variance (p≤0.05). RESULTS concentration of the antimicrobial at 22°C presented a reduction (T0-T8) and a subsequent increase (T24); hydrogenionic potential decreased significantly over time. At 37°C, the concentration increased up to T3 and decreased at T24, with a reduction of hydrogenionic potential up to 24 hours. Concentration of the vancomycin hydrochloride and heparin sodium solutions varied with a reduction at 22°C, accompanied by increased hydrogenionic potential. Precipitate formation was observed by visual inspection of the vancomycin hydrochloride-heparin sodium association (T3). CONCLUSION pharmacological stability of vancomycin hydrochloride (5 mg/mL) and physical incompatibility with heparin sodium (100 IU/mL) were evidenced after three hours of association in the antimicrobial seal solutions studied.
Collapse
Affiliation(s)
- Daniele Porto Barros
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brasil.,Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | - Priscilla Sete de Carvalho Onofre
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brasil.,Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | | | - Paulo César Pires Rosa
- Universidade Federal de São Paulo, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Diadema, SP, Brasil
| | | | | |
Collapse
|
8
|
Dong J, Liu Y, Li L, Ding Y, Qian J, Jiao Z. Interactions between meropenem and renal drug transporters. Curr Drug Metab 2022; 23:423-431. [PMID: 35490314 DOI: 10.2174/1389200223666220428081109] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/23/2021] [Accepted: 01/18/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Meropenem is a carbapenem antibiotic and commonly used with other antibiotics for the treatment of bacterial infections. It is primarily eliminated renally by glomerular filtration and renal tubular secretion. OBJECTIVE To evaluate the roles of renal uptake and efflux transporters in the excretion of meropenem and potential drug interactions mediated by renal drug transporters. METHOD Uptake and inhibition studies were conducted in human embryonic kidney 293 cells stably transfected with organic anion transporter (OAT) 1, OAT3, multidrug and toxin extrusion protein (MATE) 1 and MATE2K, as well as membrane vesicles containing breast cancer resistance-related protein (BCRP), multidrug resistance protein 1 (MDR1) and multidrug resistance-associated protein 2 (MRP2). Probenecid and piperacillin were used to assess potential drug interactions with meropenem in rats. RESULTS We observed that meropenem was a low-affinity substrate of OAT1/3 and had a weak inhibitory effect on OAT1/3 and MATE2K. BCRP, MDR1, MRP2, MATE1 and MATE2K could not mediate renal excretion of meropenem. Moreover, meropenem was not an inhibitor of BCRP, MDR1, MRP2 or MATE1. Among five tested antibiotics, moderate inhibition on OAT3-mediated meropenem uptake was observed for linezolid (IC50 value was 69.2 μM), weak inhibition was observed for piperacillin, benzylpenicillin and tazobactam (IC50 values were 282.2, 308.0 and 668.1 μM, respectively), and no inhibition was observed for sulbactam. Although piperacillin had a relatively high drug-drug interaction index (ratio of maximal unbound plasma concentration to IC50 was 1.42) in vitro, it had no meaningful impact on the pharmacokinetics of meropenem in rats. CONCLUSION Our results indicate that clinically significant interactions between meropenem and these five antibiotics are low.
Collapse
Affiliation(s)
- Jing Dong
- Department of Pharmacy, Shanghai Pudong New Area Gongli Hospital, The Second Military Medical University, 219 Miaopu Road, Shanghai 200135, China
| | - Yanhui Liu
- Department of Pharmacy, Shanghai Pudong New Area Gongli Hospital, The Second Military Medical University, 219 Miaopu Road, Shanghai 200135, China
| | - Longxuan Li
- Department of Neurology, Shanghai Pudong New Area Gongli Hospital, The Second Military Medical University, 219 Miaopu Road, Shanghai 200135, China
| | - Yunhe Ding
- Department of Pharmacy, Shanghai Pudong New Area Gongli Hospital, The Second Military Medical University, 219 Miaopu Road, Shanghai 200135, China
| | - Jun Qian
- Department of Pharmacy, Shanghai Pudong New Area Gongli Hospital, The Second Military Medical University, 219 Miaopu Road, Shanghai 200135, China
| | - Zheng Jiao
- Department of Pharmacy, Shanghai Chest Hospital, 241 West Huaihai Road, Shanghai 200030, China
| |
Collapse
|
9
|
Barros DP, Onofre PSDC, Fonseca FLA, Rosa PCP, Pedreira MDLG, Peterlini MAS. Estabilidad del clorhidrato de vancomicina utilizado en soluciones de sellado antimicrobiano para catéteres intravenosos centrales. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518.8345.5869.3622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen Objetivo: verificar la estabilidad del clorhidrato de vancomicina en soluciones de sellado antimicrobiano solo y combinado con heparina sódica según la temperatura y el tiempo de combinación. Método: estudio experimental diseñado para analizar el potencial de hidrógeno y la concentración por cromatografía líquida de alta resolución de soluciones de clorhidrato de vancomicina (n=06) y de clorhidrato de vancomicina y heparina sódica (n=06). Las soluciones estudiadas fueron sometidas a ausencia de luz, 22°C y 37°C. Se realizaron análisis por triplicado (n=192) en el momento inicial (T0), a las tres (T3), ocho (T8) y 24 horas (T24) después de la preparación. Los datos fueron sometidos a análisis de varianza (p≤0,05). Resultados: la concentración de antimicrobiano a 22°C mostró una reducción (T0-T8) y un posterior aumento (T24); el potencial de hidrógeno disminuyó significativamente con el tiempo. A 37°C, la concentración aumentó hasta T3 y disminuyó en T24, el potencial de hidrógeno disminuyó hasta las 24 horas. La concentración de las soluciones de clorhidrato de vancomicina y heparina sódica mostró variación con la reducción a 22°C acompañada de un aumento del potencial de hidrógeno. Mediante inspección visual se observó la formación de un precipitado al combinar clorhidrato de vancomicina y heparina sódica (T3). Conclusión: el clorhidrato de vancomicina (5 mg/ml) presentó evidencia de estabilidad farmacológica e incompatibilidad física con la heparina sódica (100 UI/ml) después de las tres horas de haberse realizado la combinación en las soluciones de sellado antimicrobiano estudiadas.
Collapse
Affiliation(s)
- Daniele Porto Barros
- Universidade Federal de São Paulo, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | | | | | | | | | | |
Collapse
|
10
|
Aleksić DZ, Milosavljević MN, Janković SM, Arsić ADA, Stefanović SM. Potential drug-drug interactions among patients with spontaneous intracerebral hemorrhage treated at the Neurological Intensive Care Unit: a single-center experience. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022220357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
11
|
Barros DP, Onofre PSDC, Fonseca FLA, Rosa PCP, Pedreira MDLG, Peterlini MAS. Stability of vancomycin hydrochloride employed in antimicrobial seal solutions of central intravenous catheters. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518.8345.5869.3621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective: to verify the stability of vancomycin hydrochloride in antimicrobial seal solutions with and without association of heparin sodium according to temperature and association time. Method: an experimental study designed for the analysis of hydrogenionic potential and concentration by means of high-efficiency liquid chromatography of vancomycin hydrochloride (n=06) and vancomycin hydrochloride and heparin sodium (n=06). The solutions studied were submitted to absence of light, as well as to 22°C and 37°C. Analyses in triplicate (n=192) were performed at the initial moment (T0) and three (T3), eight (T8) and 24 hours (T24) after preparation. The data were submitted to analysis of variance (p≤0.05). Results: concentration of the antimicrobial at 22°C presented a reduction (T0-T8) and a subsequent increase (T24); hydrogenionic potential decreased significantly over time. At 37°C, the concentration increased up to T3 and decreased at T24, with a reduction of hydrogenionic potential up to 24 hours. Concentration of the vancomycin hydrochloride and heparin sodium solutions varied with a reduction at 22°C, accompanied by increased hydrogenionic potential. Precipitate formation was observed by visual inspection of the vancomycin hydrochloride-heparin sodium association (T3). Conclusion: pharmacological stability of vancomycin hydrochloride (5 mg/mL) and physical incompatibility with heparin sodium (100 IU/mL) were evidenced after three hours of association in the antimicrobial seal solutions studied.
Collapse
Affiliation(s)
- Daniele Porto Barros
- Universidade Federal de São Paulo, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | | | | | | | | | | |
Collapse
|
12
|
Akdemir Kalkan İ, Çınar G, Pehlivanlı A, Ürkmez F, Topaloğlu İE, Akyol B, Onay Beşikçi A, Azap A, Memikoğlu KO. Pattern of systemic antibiotic use and potential drug interactions: Evaluations through a point prevalence study in Ankara University Hospitals. Turk J Med Sci 2021; 51:523-529. [PMID: 32927931 PMCID: PMC8203144 DOI: 10.3906/sag-2004-164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/08/2020] [Indexed: 01/01/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- İrem Akdemir Kalkan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Güle Çınar
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Aysel Pehlivanlı
- Department of Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - Fatih Ürkmez
- Department of Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - İzel Ezgi Topaloğlu
- Department of Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - Büşra Akyol
- Department of Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - Arzu Onay Beşikçi
- Department of Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - Alpay Azap
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Kemal Osman Memikoğlu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, Turkey
| |
Collapse
|
13
|
Mahboobipour AA, Baniasadi S, Shahrebabaki ES, Nejad ST, Hassanzad M. Antibiotic use evaluation in hospitalized pediatric patients with respiratory tract infections: A retrospective chart review study. Curr Drug Saf 2021; 17:17-23. [PMID: 33602106 DOI: 10.2174/1574886316666210218104644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/07/2021] [Accepted: 01/09/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Respiratory tract infections (RTIs) are a common cause of antibiotic usage in hospitalized pediatric patients. Inappropriate use of antibiotics may lead to the emergence of multidrug-resistant microorganisms and increased treatment costs. OBJECTIVE This study was designed to assess antibiotic usage in hospitalized pediatric patients with RTIs. METHODS Medical charts of the patients admitted to the pediatric ward (PW) and pediatric intensive care unit (PICU) of a tertiary respiratory center were reviewed. Patients' demographic and clinical data including gender, age, weight, history of allergy, length of hospital stay, clinical diagnosis, prescribed antibiotics (indication, dose, and frequency of administration) were collected. The appropriateness of antibiotic usage was evaluated in each patient according to international guidelines. RESULTS Two hundred seventy-nine hospitalized patients were included in the study. The most common reason for hospitalization was pneumonia (38%), followed by cystic fibrosis (20.1%) and bronchitis (5%). The most commonly used antimicrobial agents were ceftriaxone, azithromycin, and clindamycin which guideline adherence for their usage was 85.3%, 23.3%, and 47%; respectively. Inappropriate dose selection was the main reason for non-adherence to the guidelines. The adherence rate to RTIs' guidelines (considering all parameters for each patient) was 27.6%. Multivariate logistic regression analysis demonstrated CF and prescription of azithromycin are predictors of guideline non-adherence. CONCLUSION We found relatively low adherence to international guidelines in our center that could be related to restricted definitions of optimal antibiotic therapy. Despite most patients received logical antimicrobial therapy, actions should be taken into account to reach optimal antibiotic usage.
Collapse
Affiliation(s)
| | - Shadi Baniasadi
- Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran. Iran
| | - Elahe Saberi Shahrebabaki
- Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran. Iran
| | - Sabereh Tashayoie Nejad
- Pediatric Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran. Iran
| | - Maryam Hassanzad
- Pediatric Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran. Iran
| |
Collapse
|
14
|
Cattaneo D, Corona A, De Rosa FG, Gervasoni C, Kocic D, Marriott DJ. The management of anti-infective agents in intensive care units: the potential role of a 'fast' pharmacology. Expert Rev Clin Pharmacol 2020; 13:355-366. [PMID: 32320302 DOI: 10.1080/17512433.2020.1759413] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Patients in intensive care units (ICU) are often developing severe infections in which are associated with significant mortality rates. A number of novel technologies for the rapid microbiological diagnosis of these infections have been developed, introducing the era of 'fast microbiology.' Treatment of bacterial and fungal infections in ICU is however complicated by alterations in the pharmacokinetics of antimicrobial agents. AREAS COVERED We review novel pharmacologic tools that can be used to optimize anti-infective therapies and patient management in ICU. A MEDLINE Pubmed search for articles published from January 1995 to 2019 was completed matching the terms pharmacokinetics and pharmacology with antimicrobial agents and ICU or critically ill patients. Moreover, additional studies were identified from the reference list of retrieved articles. EXPERT OPINION Several tools are in development for the full automation of the analytical methods used for the quantification of antimicrobial concentrations within a few hours after sample collection. Ad hoc software with adaptive feedback is also available for appropriate dose adjustments based on both individual patient covariate data and therapeutic drug monitoring (TDM) data when available. The application of these technological improvements in the clinical practice should open the way to a 'fast pharmacology' at the bedside.
Collapse
Affiliation(s)
- Dario Cattaneo
- Unit of Clinical Pharmacology, ASST Fatebenefratelli Sacco University Hospital , Milan, Italy.,Gestione Ambulatoriale Politerapie (GAP) Outpatient Clinic, ASST Fatebenefratelli Sacco University Hospital , Milan, Italy
| | - Alberto Corona
- Intensive Care Unit, ASST Fatebenefratelli Sacco, University Hospital , Milan, Italy
| | | | - Cristina Gervasoni
- Gestione Ambulatoriale Politerapie (GAP) Outpatient Clinic, ASST Fatebenefratelli Sacco University Hospital , Milan, Italy.,Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital , Milan, Italy
| | - Danijela Kocic
- Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital Sydney , Sydney, Australia
| | - Deborah Je Marriott
- Department of Clinical Microbiology and Infectious Diseases, St Vincent's Hospital , Sydney, Australia
| |
Collapse
|