Preventability of Adverse Drug Reactions Related to Antibiotics: An Assessment Based on Spontaneous Reporting System

BACKGROUND

Antibiotics are commonly used in both outpatient and inpatient settings and are responsible for the majority of adverse drug reaction (ADR) reports. We aimed to characterize spontaneously reported ADRs associated with antibiotics and assessing the preventability of these ADRs in a Vietnamese setting.

MATERIALS AND METHODS

We conducted a retrospective descriptive study based on ADRs related to antibiotics spontaneously reported by healthcare workers to the National Pharmacovigilance Database of Vietnam (NPDV) between June 2018 and May 2019. The characteristics of included reports were descriptively analyzed. The preventability of reported ADRs was assessed using a standardized preventability scale. We identified the leading causes and described the characteristics associated with preventable ADRs (pADRs).

RESULTS

We included 6385 antibiotic-related reports from a total of 12,056 reports submitted to the NPDV during the study period. Beta-lactam antibiotics, mostly broad-spectrum with parenteral route, were suspected in the majority cases. The most commonly reported pADRs were allergic reactions, mostly classified under skin and subcutaneous tissue disorders. Of all included cases, 537 cases (8.4%) were deemed as associated with pADRs. Major causes of pADRs include potentially inappropriate prescribing (352/537, 65.5%) and re-administration of antibiotics causing prior allergy/allergies (99/537, 18.4%). The majority of pADRs involved the use of beta-lactam antibiotics with inappropriate indications.

CONCLUSION

ADRs related to antibiotic use represent more than half of ADRs spontaneously reported in Vietnam. Approximately one in every ten reported cases is associated with pADRs. The majority pADRs can be prevented through simple improvement in antibiotic prescribing practices.

Enhanced Photocatalytic Activity of Spherical Nd3+ Substituted ZnFe2O4 Nanoparticles

In this study, nanocrystalline ZnNd_xFe_2−xO₄ ferrites with x = 0.0, 0.01, 0.03 and 0.05 were fabricated and used as a catalyst for dye removal potential. The effect of Nd³⁺ ions substitution on the structural, optical and photo-Fenton activity of ZnNd_xFe_2−xO₄ has been investigated. The addition of Nd³⁺ ions caused a decrease in the grain size of ferrites, the reduction of the optical bandgap energies and thus could be well exploited for the catalytic study. The photocatalytic activity of the ferrite samples was evaluated by the degradation of Rhodamine B (RhB) in the presence of H₂O₂ under visible light radiation. The results indicated that the ZnNd_xFe_2−xO₄ samples exhibited higher removal efficiencies than the pure ZnFe₂O₄ ferrites. The highest degradation efficiency was 98.00%, attained after 210 min using the ZnNd_0.03Fe_1.97O₄ sample. The enhanced photocatalytic activity of the ZnFe₂O₄ doped with Nd³⁺ is explained due to the efficient separation mechanism of photoinduced electron and holes. The effect of various factors (H₂O₂ oxidant concentration and catalyst loading) on the degradation of RhB dye was clarified.