We conducted a retrospective analysis of spontaneous reports (SRs) about adverse drug reactions related to the beta-lactam antibiotics. All these reports were sent to the Russian safety database in the period from 01.01.2012 to 01.08.2014. To identify cases of MEs we used the Russian drug labels, standards of medical care and practical guidelines for certain diseases.
We analyzed 3798 SRs overall and detected medication errors for 1060 (28.0%) SRs. In 168 (15.8%) of these cases we discovered two or more errors. However, reporters selected medication error-related terms only in 29 (2.7%) SRs.
In 31.8% cases of wrong antimicrobials prescription the indication was absent or inappropriate, in 60.3% of these cases antibiotic was used for viral infections. 29.7% MEs occurred because of the following deviations from the recommended dosage regimen: (a) 14.6% occurred due to inappropriate schedule of drug administration; (b) 11.3% because of overdosage; (c) 3.8% occurred because of underdosage. 17.1% MEs were associated with the cases where the antibacterial drug was prescribed to a patient, who had contraindications to it. In most cases (70.8%), the errors were associated with a patient with documented hypersensitivity to administered drug or to other beta-lactams.
The highest prevalence of MEs (37.1%) was detected for penicillin derivatives. The prevalence of MEs for cephalosporins and carbapenems was 24.1% and 24.8% respectively.
In our opinion, spontaneous reporting is an effective method for identifying MEs. Strategies for reducing the prevalence of errors should focus on healthcare practitioners training, as well as on continuous professional development of doctors. Therefore, we suggest to emphasize importance of the following procedures: (a) to avoid prescribing antibiotics for treatment of viral infections; (b) to follow an appropriate dosage regimen; (c) to collect drug anamnesis accurately; and (d) to pay attention to the cross-hypersensitivity reactions.
A. Kuzmina, None
V. Polivanov, None
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