Antibiotic adverse events on an outpatient parenteral antibiotic service: a retrospective cohort study. Issue 3 (25th February 2020)

• Record Type: Journal Article
• Authors: Hanumunthadu, Brama; Breathnach, Aodhan
• Is Part Of: European journal of hospital pharmacy. Volume 28:Issue 3(2021)
• Page Start: 139
• Page End: 143
• Publication Date: 2020-02-25
• Subjects: antibiotics -- OPAT -- adverse events -- piperacillin/tazobactam -- ertapenem; Pharmacy -- Periodicals; Hospital pharmacies -- Periodicals; 615.1
• DOI: 10.1136/ejhpharm-2019-002045
• Languages: English
• ISSNs: 2047-9956

Abstract

Abstract : Objectives: To identify the rate of adverse events for ceftriaxone, ertapenem, daptomycin, teicoplanin, piperacillin/tazobactam and meropenem on an outpatient parenteral antibiotic (OPAT) service. Method: We identified all patients on our prospectively populated OPAT Access Database from 2009 to 2016. Duration on OPAT and the details of any documented antibiotic adverse/toxic events, were recorded. Results: Ertapenem was used most commonly at 356/961 (37%) specific antibiotic episode per all antibiotic episodes, followed jointly by both ceftriaxone 241/961 (25%), teicoplanin 237/961 (25%), with meropenem 59/961 (6%), piperacillin/tazobactam 42/961 (4%) and daptomycin 26/961 (3%). The total number of antibiotic adverse events for the six antibiotics being investigated was 48/961 (5%). Piperacillin/tazobactam has a significantly higher rate of adverse events compared with most of the other antibiotics studied (12/42; 29%) followed by daptomycin (3/26; 12%; p=0.1362), ceftriaxone (16/241; 7%; p=0.0001), meropenem (3/59; 5%; p=0.0015), teicoplanin (10/237; 4%; p=0.0001) and ertapenem (4/356; 1%; p=0.0001). Ertapenem has a significantly lower rate of toxicity compared with some of the other antibiotics investigated. When standardised per 1000 OPAT days, piperacillin/tazobactam continues to have a significantly higher rate of toxicity (8.3 episodes of antibiotic toxicity per 1000 OPAT days), with again ertapenem having a significant lower rate of toxicity (0.5) compared with some of the remaining antibiotics. Conclusion: While the overall number of adverse events directly attributable to the antibiotics examined was only 5%, it may be possible to optimise antibiotics to reduce this percentage.