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Nasr ZG, Elamin W, Basil M, Eljaaly K. Pharmacist-driven antimicrobial stewardship interventions in patients with COVID-19: a scoping review. Int J Clin Pharm 2023:10.1007/s11096-023-01574-0. [PMID: 37162655 PMCID: PMC10171144 DOI: 10.1007/s11096-023-01574-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 03/09/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) is a highly infectious disease that can be treated with antivirals in addition to other antimicrobials in cases of secondary or concomitant infections. This creates potential for antimicrobials misuse, which increases antimicrobial resistance (AMR). Pharmacists are known to undertake prominent roles in combatting AMR. AIM The aim of this review was to characterize pharmacist-driven interventions that have been performed in patients with COVID-19 globally and describe their impact on antimicrobial use. METHOD We followed the Joanna Briggs Institutes manual framework for scoping reviews in our study. Studies that reported antimicrobial stewardship (AMS) interventions performed by pharmacists in COVID-19 patients were included. Articles that did not report outcomes or did not mention pharmacists in the intervention were excluded. Restrictions included English-only articles from inception date until June 2022. Articles were searched from four databases. RESULTS Eleven publications were included in the review. The most common AMS intervention was pharmacist-driven interventions reported in 63.2% of all studies, followed by guideline development and application (26.3%), and medication supply coordination (10.5%), respectively. The outcomes of the interventions were difficult to compare but showed a reduction in antimicrobial use and prevention of adverse drug reactions with a relatively high acceptance rate from physicians. CONCLUSION Pharmacists played an important role in performing AMS-related interventions in COVID-19 patients and helped in the fight against the worsening of AMR during the pandemic. The impact of pharmacist-driven AMS interventions in patients with COVID-19 seemed to be positive and improved outcomes related to antimicrobial use.
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Affiliation(s)
- Z G Nasr
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
| | - W Elamin
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - M Basil
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - K Eljaaly
- Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
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2
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Carter B. Unsettling the fluidity of practice and dealing with threat: the experiences of paediatric pharmacists in response to the admission of adult COVID-19 patients requiring intensive care in a paediatric tertiary hospital. Int J Pharm Pract 2023; 31:86-94. [PMID: 36305688 PMCID: PMC9620377 DOI: 10.1093/ijpp/riac074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The COVID-19 pandemic impacted the lives of pharmacists, resulting in new ways of working. Little literature focuses on the experiences and well-being of hospital pharmacists, particularly on paediatric pharmacists. The setting - a paediatric stand-alone tertiary hospital - opened to adult ICU COVID-19 patients for two time periods. Paediatric pharmacists had to shift their roles; this impacted their well-being. Paediatric ICU clinical psychologists provided support using a compassion-focused therapy (CFT) model to guide thinking, reflection and promoting behaviour change. This study aimed to explore the experiences and perceptions of the paediatric pharmacists working in a paediatric stand-alone tertiary hospital before, during and after the admission of adult COVID-19 patients into ICU and their experiences of support offered by clinical psychologists. METHODS A qualitative interpretative design using remote photo-elicitation interviews was adopted. Data analysis was undertaken using the six stages of reflexive thematic analysis. KEY FINDINGS Five paediatric pharmacists participated; four deployed to work in the A-ICU (from PICU) and one deployed to work in the PICU (from ward-based work). An overarching theme, 'Unsettling the fluidity of practice and dealing with threat', is supported by four key themes 'Context and preparation', 'Dread and challenges', 'Keeping it together' and 'Lessons learned'. The fluidity of the pharmacists' practice was unsettled as they dealt with the threats and sought resources (drive) to enable optimal care delivery. Soothe techniques helped compensate for threats, and promote resilience and well-being. CONCLUSION The CFT model has been useful in the longer term with the adoption of a more open, compassionate approach to their work and colleagues.
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Affiliation(s)
- Bernie Carter
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
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3
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Kambayashi D, Manabe T, Hirohara M. Adaptations in the role of pharmacists under the conditions of the COVID-19 pandemic: a systematic review and meta-analysis. BMC Health Serv Res 2023; 23:72. [PMID: 36691043 PMCID: PMC9870779 DOI: 10.1186/s12913-023-09071-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/16/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Community pharmacists actively engage in managing the health of local residents, but the COVID-19 pandemic has necessitated rapid adaptations in practice activities. OBJECTIVES We sought to identify the specific adaptations in practice and the expanded roles of community pharmacists in response to the COVID-19 pandemic. METHODS We conducted a systematic review of published studies reporting the tasks of pharmacists in community pharmacies or who were involved in pharmacy practices addressing the pandemic. Two investigators independently searched PubMed (December 2019-January 2022) for eligible articles. We conducted a meta-analysis to measure the frequencies of practical activities by pharmacists in response to COVID-19. RESULTS We identified 30 eligible studies. Meta-analysis of these studies found that the most commonly reported adaptation in pharmacist practice activities was modifying hygiene behaviors, including regular cleaning and disinfection (81.89%), followed by maintaining social distance from staff and clients (76.37%). Educating clients on COVID-19 was reported by 22 studies (72.54%). Telemedicine and home delivery services were provided to clients by 49.03 and 41.98% of pharmacists, respectively. CONCLUSIONS The roles of community pharmacists in public health activities have adapted and expanded in response to COVID-19, notably by incorporating public health education activities.
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Affiliation(s)
- Dan Kambayashi
- grid.412579.c0000 0001 2180 2836Laboratory of Pharmacy Practice, Center for Education and Research on Clinical Pharmacy, Showa Pharmaceutical University, Machida, Tokyo 194-8543 Japan ,grid.260433.00000 0001 0728 1069Department of Medical Innovation, Nagoya City University Graduate School of Medicine, Nagoya, Aichi 467-8601 Japan
| | - Toshie Manabe
- grid.260433.00000 0001 0728 1069Department of Medical Innovation, Nagoya City University Graduate School of Medicine, Nagoya, Aichi 467-8601 Japan ,grid.260433.00000 0001 0728 1069Center for Clinical Research, Nagoya City University West Medical Center, Nagoya, Aichi 462-8508 Japan
| | - Masayoshi Hirohara
- grid.412579.c0000 0001 2180 2836Laboratory of Pharmacy Practice, Center for Education and Research on Clinical Pharmacy, Showa Pharmaceutical University, Machida, Tokyo 194-8543 Japan
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Ahmed A, Tanveer M, Shrestha S, Khatiwada AP, Khanal S, Dujaili JA, Paudyal V. Interventions and Impact of Pharmacist-Delivered Services for People Infected with COVID-19: A Systematic Review. Healthcare (Basel) 2022; 10:1630. [PMID: 36141242 PMCID: PMC9498522 DOI: 10.3390/healthcare10091630] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022] Open
Abstract
Pharmacists are essential members of the healthcare team. The emergence of the novel coronavirus disease 2019 (COVID-19) pandemic has led pharmacists to undertake additional clinical roles. We aim to conduct a systematic review on the interventions and impact of pharmacist-delivered services in managing COVID-19 patients. We searched PubMed, Embase, Scopus, CINAHL plus, International Pharmaceutical Abstracts, and Web of Science from 1 December 2019 (the first case of COVID-19 emerged) to 13 January 2022 to retrieve the articles. Cochrane handbook and PRISMA guidelines were followed respectively to perform and report the review. The pharmacist-led interventions were reported following the Descriptive Elements of Pharmacist Intervention Characterization Tool (DEPICT) version 2. The protocol of systematic review was registered on PROSPERO (CRD42021277128). Studies quality was assessed with the modified NOS scale. In total, 7 observational studies were identified from 10,838 studies. Identification of dosage errors (n = 6 studies), regimen modifications (n = 5), removal of obsolete/duplicate medications (n = 5), identification and management of adverse drug reactions (n = 4), drug interactions prevention (n = 2), and physicians acceptance rate (n = 3) of therapy-related services delivered in-person or via tele-pharmacy were among the pharmacist-delivered services. Common interventions delivered by pharmacists also included optimizing the use of antibacterial, antivirals, and anticoagulants in COVID-19 infected patients. The acceptance of pharmacist-delivered services by physicians was high (88.5–95.5%). Included studies have described pharmacists’ beneficial role in managing patients with COVID-19 including detection, resolution, and prevention of medication-related problems, with physicians demonstrating high trust in pharmacists’ advice. Future research should assess the feasibility and scalability of such roles in real-world settings.
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Santos AP, Gonçalves LC, Oliveira ACC, Queiroz PHP, Ito CRM, Santos MO, Carneiro LC. Bacterial Co-Infection in Patients with COVID-19 Hospitalized (ICU and Not ICU): Review and Meta-Analysis. Antibiotics (Basel) 2022; 11:antibiotics11070894. [PMID: 35884147 PMCID: PMC9312179 DOI: 10.3390/antibiotics11070894] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/14/2022] [Accepted: 06/22/2022] [Indexed: 01/27/2023] Open
Abstract
The prevalence of patients hospitalized in ICUs with COVID-19 and co-infected by pathogenic bacteria is relevant in this study, considering the integrality of treatment. This systematic review assesses the prevalence of co-infection in patients admitted to ICUs with SARS-CoV-2 infection, using the PRISMA guidelines. We examined the results of the PubMed, Embase, and SciELO databases, searching for published English literature from December 2019 to December 2021. A total of 542 rec ords were identified, but only 38 were eligible and, and of these only 10 were included. The tabulated studies represented a sample group of 1394 co-infected patients. In total, 35%/138 of the patients were co-infected with Enterobacter spp., 27% (17/63) were co-infected with methicillin-sensitive Staphylococ cus aureus, 21% (84/404) were co-infected with Klebsiella spp., 16% (47/678) of patients were co-infected with coagulase-negative Staphylococcus, 13% (10/80) co-infected with Escherichia coli (ESBL), and 3% (30/1030) of patients were co-infected with Pseudomonas aeruginosa. The most common co-infections were related to blood flow; although in the urinary and respiratory tracts of patients Streptococcus pneumoniae was found in 57% (12/21) of patients, coagulase negative Staphylococcus in 44% (7/16) of patients, and Escherichia coli was found in 37% (11/29) of patients. The present research demonstrated that co-infections caused by bacteria in patients with COVID-19 are a concern.
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Affiliation(s)
- Adailton P. Santos
- Medicine College, Federal University of Goiás, 235 Street, Goiânia 74690-900, Brazil; (A.P.S.); (L.C.G.); (A.C.C.O.); (P.H.P.Q.); (M.O.S.)
| | - Lucas C. Gonçalves
- Medicine College, Federal University of Goiás, 235 Street, Goiânia 74690-900, Brazil; (A.P.S.); (L.C.G.); (A.C.C.O.); (P.H.P.Q.); (M.O.S.)
| | - Ana C. C. Oliveira
- Medicine College, Federal University of Goiás, 235 Street, Goiânia 74690-900, Brazil; (A.P.S.); (L.C.G.); (A.C.C.O.); (P.H.P.Q.); (M.O.S.)
| | - Pedro H. P. Queiroz
- Medicine College, Federal University of Goiás, 235 Street, Goiânia 74690-900, Brazil; (A.P.S.); (L.C.G.); (A.C.C.O.); (P.H.P.Q.); (M.O.S.)
| | - Célia R. M. Ito
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 Street, Goiânia 74605-050, Brazil;
| | - Mônica O. Santos
- Medicine College, Federal University of Goiás, 235 Street, Goiânia 74690-900, Brazil; (A.P.S.); (L.C.G.); (A.C.C.O.); (P.H.P.Q.); (M.O.S.)
| | - Lilian C. Carneiro
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 Street, Goiânia 74605-050, Brazil;
- Correspondence: ; Tel.: +55-(62)-32096528
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Jia X, Zhang W, Du S, Wen L, Li H, Yin Z, Li J, Zhang X. What Is the Role of Pharmacists in Treating COVID-19 Patients? The Experiences and Expectations of Front Line Medical Staff. Front Public Health 2022; 9:778863. [PMID: 34988052 PMCID: PMC8720774 DOI: 10.3389/fpubh.2021.778863] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/26/2021] [Indexed: 12/23/2022] Open
Abstract
Aims: The study aimed to understand the role and the core values of pharmacists and the professional expectations of medical staff for pharmacists in treating COVID-19 patients from the perspectives of the frontline medical staff. The findings help to understand and provide a reference for the career growth path of future pharmacists. Methods: A phenomenological method was used to conduct in-depth interviews with frontline medical staff working in isolation wards during COVID-19. The interview data were analyzed, and the themes were extracted. Results: Pharmacists played a positive role in ensuring the supply of non-routinely stocked drugs, including traditional Chinese medicine preventative preparations, providing drug information and medication consultation for complex patients, and identifying adverse drug reactions. However, at present, the integration of pharmacists and nurses is poor with inadequate communication, and the pharmaceutical care activities provided to physicians were still not comprehensive. Conclusions: The level of pharmaceutical care provided by pharmacists needs to be further strengthened. Frontline medical teams generally have high professional expectations for pharmacists, including expecting pharmacists to become drug therapy experts. They expect pharmacists to fully participate in clinical decision-making, especially playing a central role in managing drug interactions, contraindications, and other clinical uses of drugs.
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Affiliation(s)
- Xuedong Jia
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wan Zhang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shuzhang Du
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Linlin Wen
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongye Li
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhao Yin
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jun Li
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaojian Zhang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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7
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Yang D, Ma X, Fu S, Zhao J, Aierken A, Teng L, Gao X. COVID-19 Knowledge and Pandemic-Associated Distress Among the Hospital Pharmacist Workforce in China. Disaster Med Public Health Prep 2021; 17:e75. [PMID: 34819206 DOI: 10.1017/dmp.2021.343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The unprecedented disruption brought about by the global coronavirus disease 2019 (COVID-19) pandemic had produced tremendous influence on the practice of pharmacy. Sufficient knowledge of pharmacists was needed to deal with the epidemic situation; however, outbreak also aggravated psychological distress among health-care professionals. Therefore, this study aimed to determine knowledge about the pandemic and related factors, prevalence and factors associated with psychological distress among hospital pharmacists of Xinjiang Province, China. METHODS An anonymous online questionnaire-based cross-sectional study was conducted by means of WeChat, a popular social media platform in China, February 23-27, 2020, during the COVID-19 outbreak. The survey questionnaire consisted of 4 parts, including informed consent section, demographic section, knowledge about COVID-19, and assessment of overall mental health through World Health Organization's Self-Reporting Questionnaire (SRQ-20). A score of 8 or above on SRQ-20 was used as cutoff to classify the participant as in psychological distress. SRQ-20 score and related knowledge score were used as dependent variables, demographic characteristics (such as gender, age, monthly income, etc.) were used as independent variables, and univariate binary logistic regression was used to screen out the variables with P < 0.05. Then, the filtered variables were used as independent variables, and multivariate logistic regression models were used to analyze associations with sufficient knowledge of COVID-19 and psychological distress. RESULTS A total of 365 pharmacists participated in the survey, fewer than half (35.1%; n = 128) of pharmacists attained a score of 6 or greater (out of 10) in overall disease knowledge, and most were able to select effective disinfectants and isolation or discharge criteria. In the multivariable model, age ages 31-40 (odds ratio [OR] = 3.25; P < 0.05), ages 41-50 (OR = 2.96; P < 0.05) versus >50 (referent); primary place of practice in hospitals: drug supply (OR = 4.00; P < 0.01), inpatient pharmacy (OR = 2.06, P < 0.01), clinical pharmacy (OR = 2.17, P < 0.05) versus outpatient pharmacy (referent); monthly income Renminbi (RMB, China's legal currency) 5000-10,000 (OR = 1.77; P < 0.05) versus < 5000 (referent); contact with COVID-19 patients or suspected cases (OR = 2.27; P < 0.01); access to COVID-19 knowledge remote work+ on-site work (OR = 6.07; P < 0.05), single on-site work (OR = 6.90; P < 0.01) versus remote work (referent) were related to better knowledge of COVID-19. Research found that 18.4% of pharmacists surveyed met the SRQ-20 threshold for distress. Self-reported history of mental illness (OR = 3.56; P < 0.05) and working and living in hospital versus delay in work resumption (OR = 2.87; P < 0.01) were found to be risk factors of psychological distress. CONCLUSIONS Further training of COVID-19 knowledge was required for pharmacists. As specific pharmacist groups were prone to psychological distress, it was important for individual hospitals and government to consider and identify pharmacists' needs and take steps to meet their needs with regard to pandemic and other work-related distress.
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Ghibu S, Juncan AM, Rus LL, Frum A, Dobrea CM, Chiş AA, Gligor FG, Morgovan C. The Particularities of Pharmaceutical Care in Improving Public Health Service during the COVID-19 Pandemic. Int J Environ Res Public Health 2021; 18:9776. [PMID: 34574698 PMCID: PMC8468206 DOI: 10.3390/ijerph18189776] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/11/2022]
Abstract
Nowadays, humanity is confronted with one of the most difficult challenges. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified for the first time in Hubei, China in December 2019 and produced the COVID-19 pandemic, a devastating disease that led to many complications and deaths. The authorities and the global healthcare system have been alerted regarding the prevention and treatment of this pathology. Even though worldwide quarantine was declared, health care professionals, including pharmacists, have been at the frontline in this war. Since the beginning of the pandemic, the authorities relied on the involvement of the community, hospital, or clinical pharmacists in offering support to the entire population. Also, the authorities implemented measures for emergency authorization of the vaccines, or the drugs used in COVID-19 treatment. In order to facilitate the population's access to healthcare services, the authorities have established regulations regarding, the extension of prescriptions by pharmacists, working hours, prevention of shortages and price-increase, drive-thru services, etc. However, several countries have taken financial measures to support the pharmacies' activity. At the same time, pharmaceutical associations elaborated guidelines for the protection of pharmacists and patients alike. Additionally, the pharmacies have come to support the health system and patients by adapting pharmaceutical care to the new needs like preparation and supply of disinfectants, patient care, information, and counseling, especially to COVID-19 patients, as well as the implementation of home drugs-delivery systems. The important roles played by pharmacists were to perform COVID-19 tests and further vaccines, as well as to combat the abundance of misinformation and fake news. The clinical and hospital pharmacy services have also been adapted. Strengthening the role of the pharmacist in the medical team was important for the purpose of providing correct and complete information regarding drugs used in the COVID-19 pathology. In all these activities, pharmacists needed creativity and professionalism, but also the support of pharmacy owners and managers. With this crisis, pharmaceutical care has entered a new phase, demonstrating the ability of pharmacists to be competent and accessible providers of public health. Based on this information, we conducted a narrative review whose purpose was to identify the impact of the authorities' decisions on pharmaceutical practice, the involvement of professional associations, and the responsibilities of the pharmacy owners and management. On the other hand, we performed a global assessment on the pharmaceutical care services provided by community pharmacists as well as by clinical or hospital pharmacists during the COVID-19 pandemic.
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Affiliation(s)
- Steliana Ghibu
- Department of Pharmacology, Physiology and Pathophysiology, Faculty of Pharmacy, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6A Louis Pasteur Street, 400349 Cluj-Napoca, Romania;
| | - Anca Maria Juncan
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.M.J.); (L.L.R.); (A.F.); (C.M.D.); (F.G.G.); (C.M.)
| | - Luca Liviu Rus
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.M.J.); (L.L.R.); (A.F.); (C.M.D.); (F.G.G.); (C.M.)
| | - Adina Frum
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.M.J.); (L.L.R.); (A.F.); (C.M.D.); (F.G.G.); (C.M.)
| | - Carmen Maximiliana Dobrea
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.M.J.); (L.L.R.); (A.F.); (C.M.D.); (F.G.G.); (C.M.)
| | - Adriana Aurelia Chiş
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.M.J.); (L.L.R.); (A.F.); (C.M.D.); (F.G.G.); (C.M.)
| | - Felicia Gabriela Gligor
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.M.J.); (L.L.R.); (A.F.); (C.M.D.); (F.G.G.); (C.M.)
| | - Claudiu Morgovan
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.M.J.); (L.L.R.); (A.F.); (C.M.D.); (F.G.G.); (C.M.)
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Abu-Rub LI, Abdelrahman HA, Johar ARA, Alhussain HA, Hadi HA, Eltai NO. Antibiotics Prescribing in Intensive Care Settings during the COVID-19 Era: A Systematic Review. Antibiotics (Basel) 2021; 10:935. [PMID: 34438985 PMCID: PMC8389042 DOI: 10.3390/antibiotics10080935] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/18/2021] [Accepted: 07/26/2021] [Indexed: 02/07/2023] Open
Abstract
The prevalence of patients admitted to intensive care units (ICUs) with SARS-CoV-2 infection who were prescribed antibiotics is undetermined and might contribute to the increased global antibiotic resistance. This systematic review evaluates the prevalence of antibiotic prescribing in patients admitted to ICUs with SARS-CoV-2 infection using PRISMA guidelines. We searched and scrutinized results from PubMed and ScienceDirect databases for published literature restricted to the English language up to 11 May 2021. In addition, we included observational studies of humans with laboratory-confirmed SARS-CoV-2 infection, clinical characteristics, and antibiotics prescribed for ICU patients with SARS-CoV-2 infections. A total of 361 studies were identified, but only 38 were included in the final analysis. Antibiotic prescribing data were available from 2715 patients, of which prevalence of 71% was reported in old age patients with a mean age of 62.7 years. From the reported studies, third generation cephalosporin had the highest frequency amongst reviewed studies (36.8%) followed by azithromycin (34.2%). The estimated bacterial infection in 12 reported studies was 30.8% produced by 15 different bacterial species, and S. aureus recorded the highest bacterial infection (75%). The fundamental outcomes were the prevalence of ICU COVID-19 patients prescribed antibiotics stratified by age, type of antibiotics prescribed, and the presence of co-infections and comorbidities. In conclusion, more than half of ICU patients with SARS-CoV-2 infection received antibiotics, and prescribing is significantly higher than the estimated frequency of identified bacterial co-infection.
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Affiliation(s)
- Lubna I. Abu-Rub
- Biomedical Research Center, Qatar University, Doha 2713, Qatar; (L.I.A.-R.); (H.A.A.); (H.A.A.)
| | - Hana A. Abdelrahman
- Biomedical Research Center, Qatar University, Doha 2713, Qatar; (L.I.A.-R.); (H.A.A.); (H.A.A.)
| | | | - Hashim A. Alhussain
- Biomedical Research Center, Qatar University, Doha 2713, Qatar; (L.I.A.-R.); (H.A.A.); (H.A.A.)
| | - Hamad Abdel Hadi
- Communicable Diseases Centre, Infectious Disease Division, Hamad Medical Corporation, Doha 3050, Qatar;
| | - Nahla O. Eltai
- Biomedical Research Center, Qatar University, Doha 2713, Qatar; (L.I.A.-R.); (H.A.A.); (H.A.A.)
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Alwhaibi A, Alrwaished A, Binobydaan SM, Alawwad S, Wajid S, Bablghaith S, Alghadeer S, Al Arifi MN. Role of pharmacist during COVID-19 pandemic: A retrospective study focused on critically ill COVID-19 patients. Saudi Pharm J 2021. [PMID: 34305425 DOI: 10.1016/j.jsps.2021.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/04/2021] [Indexed: 01/14/2023] Open
Abstract
Background and aim During the Coronavirus 2019 (COVID-19) crisis, there has been a huge demand for medications and unprecedented utilization of intensive care unit (ICU) services that subsequently and profoundly impacted the quality of medical care provided to COVID-19 patients. This study aimed to shed light on the role of pharmacists on the health care provided to critically ill COVID-19 patients. Methods A retrospective study, was conducted in Diriyah hospital in Riyadh, Saudi Arabia on all COVID-19 patients admitted to the ICU between June 27th and August 15th, 2020 until patients were transferred to the medical ward, discharged, or deceased. All medication related interventions performed by pharmacists have been documented electronically, collected and subsequently categorized and analyzed. Results The mean age of patients was 58.8 years (±12.98 SD), with age of >64 years in approximately 37%. Four hundred and seventy interventions (470) were made by pharmacists of which 32%, 11.7%, 4%, 2.6%, 2.1% were due to error in dosing regimens, drug duplication, missing drug information, drugs requiring prior authorization, and missing critical information, respectively; while 40.6% were due to medication shortage of which 40.3% were substituted with alternative medications. Based on the analysis of drugs involved in interventions, medication groups that were mainly associated with interventions included antibiotics (16.8%), electrolytes/minerals (11.7%) and vitamins (9.4%). Conclusion During health crises such as COVID-19 pandemic, the role of pharmacists in the ICU services becomes extremely crucial for providing better patients’ outcomes. Further studies should be conducted to follow up these findings in the context of COVID-19 pandemic.
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