Drug-related problems on antibiotic therapy among patients in the intensive care unit at a Grade 1 Hospital, Ho Chi Minh City

Abstract

Objectives: To determine prevalence, characteristics, and factors related to drug-related problems (DRPs) of antibiotic therapy among patients in the intensive care unit at a grade 1 hospital, Ho Chi Minh City.

Materials and methods: A descriptive cross-sectional study was conducted on 132 medical records of patients with antibiotics from January 2022 to December 2022 in the intensive care unit at a grade 1 hospital, Ho Chi Minh city. DRPs were assessed using following documents: The Sanford guide on antimicrobial therapy 2022, Antimicrobial guideline 2022 in hospital where we conducted this study, Vietnamese National Drug Formulary 2018, summary of product characteristics, Micromedex and eMC. DRPs were classified according to the Pharmaceutical Care Network Europe system version 9.1. Multivariable logistic regression analysis was used to determine the predictors of DRPs.

Results: In total, 332 DRPs were identified and 84.8% medical records had at least one DRP involving antibiotics. Inappropriate problems related to dosage (58.1%), serious drug interactions (36.2%), inappropriate administration (4.5%), and inappropriate indication (1.2%) were identified. Female patients related to an increased risk of DRPs compared to male patients (OR = 4.138; 95%; CI: 1.052 – 16.271; p = 0.042). Patients with eGFR ≥ 60 mL/min/1,73m2 were less likely to experience DRPs (OR = 0.197; 95% CI: 0.051 – 0.765; p = 0.019). Patients who received five or more drugs were more likely to experience DRPs than those using fewer drugs (OR = 6.068; 95% CI: 1.489 – 24.725; p = 0.012).

Conclusions: The prevalence of drug-related problems on antibiotic therapy in the intensive care unit was found to be high. Further prospective studies are warranted to determine the clinical impact of DRPs and appropriate interventions on antimicrobials in the intensive care unit are needed to improve DRPs.