Burden of enteral supplement interactions with common antimicrobial agents: a single-centre observational analysis
File(s)
Author(s)
Hughes, Stephen
Heard, Katie
Mughal, Nabeela
Moore, Luke Stephen Proctor
Type
Journal Article
Abstract
INTRODUCTION: Oral antimicrobials, including ciprofloxacin, levofloxacin and doxycycline, are susceptible to binding with enteral therapies such as calcium and iron therapies. Administered together, the bioavailability of these antimicrobials is expected to be reduced. METHODS: A retrospective case series of patients receiving oral antimicrobials (ciprofloxacin, levofloxacin and doxycycline) was analysed at a single-centre NHS acute hospital (April 2016-September 2019). Patient demographics, including concurrent enteral therapies, were recorded using medical records. Clinically important interactions were defined as doses administered within 2 hours of antimicrobial therapy. RESULTS: A total of 4067 prescriptions for the study antimicrobials (ciprofloxacin, n=1905; levofloxacin, n=538; and doxycycline, n=1624) were prescribed for 3584 patients. 1918/3583 (53.5%) of the patients were female, and the median age was 67 years (range 0.5-105.0 years). 810/4067 (19.3%) prescriptions reviewed had an interacting enteral therapy (calcium or iron salt) administered within 2 hours of the study medication. CONCLUSION: The concomitant administration of enteral calcium and iron with oral antimicrobials is common within the acute care hospital setting. Approximately one in five patients has a clinically important interaction which may impair oral bioavailability and limit treatment efficacy. As antimicrobial stewardship teams strive for increased intravenous-to-oral de-escalation, it is important that optimum dosing administration is followed to optimise patient outcomes.
Date Issued
2022-08-23
Date Acceptance
2020-12-08
Citation
European Journal of Hospital Pharmacy, 2022, 29, pp.280-283
ISSN
2047-9956
Publisher
BMJ Publishing Group
Start Page
280
End Page
283
Journal / Book Title
European Journal of Hospital Pharmacy
Volume
29
Copyright Statement
© European Association of Hospital Pharmacists 2021. No commercial re-use. See rights and permissions. Published by BMJ. This article has been accepted for publication in European Journal of Hospital Pharmacy following peer review. The definitive copyedited, typeset version Hughes S, Heard K, Mughal N, et alBurden of enteral supplement interactions with common antimicrobial agents: a single-centre observational analysisEuropean Journal of Hospital Pharmacy Published Online First: 07 January 2021 is available online at: http://dx.doi.org/10.1136/ejhpharm-2020-002445
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/33414257
PII: ejhpharm-2020-002445
Subjects
DRUG INCOMPATIBILITY
Drug Administration Routes
HOSPITAL
MICROBIOLOGY
PHARMACY ADMINISTRATION
PHARMACY SERVICE
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2021-01-07