+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Assessment of Prescribing and Monitoring Habits for Patients Taking an Antiarrhythmic and Concomitant QTc-Prolonging Antibiotic

Assessment of Prescribing and Monitoring Habits for Patients Taking an Antiarrhythmic and Concomitant QTc-Prolonging Antibiotic

Pharmacy 5(4)

Patients may intermittently require antimicrobial therapy with a QTc-prolonging antibiotic, which presents a challenge for prescribers of patients already taking a QTc-prolonging antiarrhythmic. Manufacturers recommend close monitoring for evidence of QTc-prolongation with the concomitant use of QTc-prolonging medications, but the monitoring parameters are not well-defined. Previous studies recommend a surveillance electrocardiogram (EKG) be completed both before and after the initiation of QTc-prolonging medications, but it is unknown to what degree EKGs displaying the QTc-interval are used to alter physician order entry and pharmacist order verification during concomitant therapy. A retrospective chart review was conducted between October 2015-September 2016 to assess prescribing and monitoring habits for patients taking an antiarrhythmic and a concomitant QTc-prolonging antibiotic. Of the 42 patients who received at least one dose of two QTc-prolonging agents, 36 (85.7%) received a baseline EKG, and 23 (63.8%) received a follow-up EKG. Pharmacists intervened on this drug-drug interaction and recommended follow-up EKGs only three times (8.3%) and offered alternative therapy recommendations once (2.8%). The QTc-interval was not optimally monitored in some instances for patients concomitantly receiving two QTc-prolonging agents. These results stress the importance of inter-professional communication to place an emphasis on follow-up monitoring or use of alternative therapy agents to avoid the drug-drug interaction altogether.

(PDF emailed within 0-6 h: $19.90)

Accession: 059410112

Download citation: RISBibTeXText

PMID: 29104235

DOI: 10.3390/pharmacy5040061

Related references

Moxifloxacin has a favorable cardiovascular safety profile in patients taking concomitant QTc prolonging drugs. Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 40: 476, 2000

Antibiotic-prescribing habits of nurse practitioners treating adult patients: antibiotic use and guidelines survey adult. Journal of the American Academy of Nurse Practitioners 19(4): 212-214, 2007

Drug resistance and treatment failure in leishmaniasis: A 21st century challenge. Plos Neglected Tropical Diseases 11(12): E0006052, 2017

Antibiotic prescribing habits of nurse practitioners treating pediatric patients: AntiBUGS pediatrics. Journal of the American Academy of Nurse Practitioners 19(6): 332-334, 2007

Antibiotic prescribing habits of vets in Australia. Australian Veterinary Journal 90(8): N2, 2012

The persistence of prescribing habits: a survey and follow-up of prescribing to chronic hospital in-patients. British Journal of Psychiatry 150: 88-91, 1987

Assessment of the Appropriateness of Antibiotic Prescriptions in Lesotho Public Hospitals: A Novel Methodology Based on Principles of Antibiotic Prescribing. Journal of Public Health in Africa 5(1): 354, 2014

Physicians' antibiotic prescribing habits for upper respiratory tract infections in Turkey. Journal of ChemoTherapy 14(2): 181-184, 2002

Acute respiratory tract infection: a practice examines its antibiotic prescribing habits. Journal of Family Practice 61(6): 330-335, 2012

Factors influencing antibiotic prescribing habits and use of sensitivity testing amongst veterinarians in Europe. Veterinary Record 173(19): 475, 2014

Antibiotic-prescribing habits among Norwegian dentists: a survey over 25 years (1990-2015). European Journal of Oral Sciences 125(4): 280-287, 2017

A needs assessment study for optimising prescribing practice in secondary care junior doctors: the Antibiotic Prescribing Education among Doctors (APED). Bmc Infectious Diseases 16(1): 456, 2017

Prevention of surgical site infection and appropriateness of antibiotic prescribing habits in plastic surgery. Journal of Plastic, Reconstructive and Aesthetic Surgery 61(11): 1347-1356, 2008

Monitoring drug utilization--modification of physician prescribing habits. Canadian Journal of Hospital Pharmacy 30(1): 13-15, 1976

QT-prolonging effects of sparfloxacin, a fluoroquinolone antibiotic, assessed in the in vivo canine model with monophasic action potential monitoring. Journal of Cardiovascular Pharmacology 36(4): 510-515, 2000