Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
권호 표지

Evaluation of Azithromycin Prescriptions for Pediatric Patients

소아환자에서 아지스로마이신 처방 분석

  • 오은경 (동덕여자대학교 약학대학) ;
  • 유기연 (동덕여자대학교 약학대학)
  • Received : 2016.05.31
  • Accepted : 2016.06.17
  • Published : 2016.06.30
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Abstract

Background: Azithromycin has broad spectrum and is effective to treat several bacterial respiratory tract infection. It is also relatively safe and tolerable to pediatric patient. Careful use of azithromycin is also required for the prescribers because it could cause cardiovascular toxicity (QTc prolongation) and ototoxicity. There has been no study on duration of azithromycin use in pediatric patients in Korea. Methods: The outpatient sample data on the azithromycin prescription was obtained from Korean health insurance review and assessment service. The characteristics of azithromycin prescription were analyzed with two different years (2011 and 2014). Results: Total 4,215 cases were analyzed. The azithromycin was prescribed the most frequently in the children (73.2% in 2011 and 62.5% in 2014) and for the condition of bronchopneumonia (28.7% in 2011 and 21.7% in 2014) in both years. The duration of prescribed for azithromycin has significantly different between 2011 and 2014. In 2014, 94.3% of prescription were indicated less than 5 days, but 86.6% were in 2011. Acute bronchiolitis and bronchopneumonia prescriptions more longer duration of treatment compared with acute bronchitis and others. Conclusion: The pattern of prescribing azithromycin has been changed for the treatment of several infectious diseases in pediatric patients. The rate of appropriate duration of azithromycin treatment has increased.

Keywords

References

  1. Drew RH, Gallis HA. Azithromycin-spectrum of activity, pharmacokinetics, and clinical Applications. Pharmacotherapy 1992;12:161-73.
  2. Bahal N, Nahata MC. The new macrolide antibiotics: azithromycin, clarithromycin, dirithromycin, and roxithromycin. Ann Pharmacother 1992;26:46-55. https://doi.org/10.1177/106002809202600112
  3. MFDS. Drug information. Available from https://ezdrug.mfds.go.kr. Accessed May 5, 2016.
  4. Chow AW, Benninger MS, Brook I, et al. IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults. Clin Infect Dis 2012;54:e72-e112. https://doi.org/10.1093/cid/cis370
  5. Bradley JS, Byington CL, Shah SS, et al. The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis 2011;53:e25-76. https://doi.org/10.1093/cid/cir531
  6. Pickering LK, Baker CJ, Kimberlin DW, et al. Red Book: 2012 Report of the Committee on Infectious Diseases. 29th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2012.
  7. Ray WA, Murray KT, Hall K, et al. Azithromycin and the risk of cardiovascular death. N Engl J Med 2012;366:1881-90. https://doi.org/10.1056/NEJMoa1003833
  8. Bizjak ED, Haug MT, Schilz RJ, et al. Intravenous azithromycininduced ototoxicity. Pharmacotherapy 1999;19:245-8. https://doi.org/10.1592/phco.19.3.245.30930
  9. Eric M, Ethan AH, Mary Jo Pugh, et al. Association of azithromycin with mortality and cardiovascular events among older patients hospitalized with pneumonia. JAMA 2014;311:2199-208. https://doi.org/10.1001/jama.2014.4304
  10. Mortensen EM, Halm EA, Pugh MJ, et al. Efficacy and safety of longterm antibiotics (macrolides) for the treatment of chronic rhinosinusitis. Curr Allergy Asthma Rep 2014;14:416-22. https://doi.org/10.1007/s11882-013-0416-2
  11. Svanstrom H, Pasternak B, Hviid A. Use of azithromycin and death from cardiovascular causes. N Engl J Med 2013;368:1704-12. https://doi.org/10.1056/NEJMoa1300799
  12. FDA. Drug information. Available from www.fda.gov/Drugs/Drugs-Dafety/ucm341822.htm. Accessed April 21, 2016.
  13. MFDS. Drug information for pediatric patients. Available from http://drug.mfds.go.kr/eBook/access/ecatalog_sp.jsp?callmode=&catimage=&Dir=13&cpage=2. Accessed April 23, 2016.
  14. Kogan R, Martinez MA, Rubilar L, et al. Comparative randomized trial of azithromycin versus erythromycin and amoxicillin for treatment of community-acquired pneumonia in children. Pediatr Pulmonol 2003;35:91-8. https://doi.org/10.1002/ppul.10180
  15. Arguedas A, Soley C, Kamicker BJ, et al. Single-dose extended-release azithromycin versus a 10-day regimen of amoxicillin/clavulanate for the treatment of children with acute otitis media. Int J Infect Dis 2011;15:240-8. https://doi.org/10.1016/j.ijid.2010.12.003
  16. Patel C, Tao G, Gorwitz R, et al. 1-2 Grams of azithromycin and cardiovascular death among commercially insured persons aged 15-44 years. Sex Transm Dis 2014;41(S130).
  17. Lloyd M, Watmough SD, O'Brien SV, et al. Exploring attitudes and opinions of pharmacists toward delivering prescribing error feedback: A qualitative case study using focus group interviews. Res Social Adm Pharm 2016;12:461-74. https://doi.org/10.1016/j.sapharm.2015.08.012
  18. Sethuraman U, Kannikeswaran N, Murray KP, et al. Prescription errors before and after introduction of electronic medication alert system in a pediatric emergency department. Acad Emerg Med 2015;22:714-9. https://doi.org/10.1111/acem.12678
  19. Kabbara WK, Ramadan WH, Rahbany P, et al. Evaluation of the appropriate use of commonly prescribed fluoroquinolones and the risk of dysglycemia. Ther Clin Risk Manag 2015;22:639-47.
  20. Murphy JL, Fenn N, Pyle L, et al. Adverse events in pediatric patients receiving long-term oral and intravenous antibiotics. Hosp Pediatr 2016;6:330-8. https://doi.org/10.1542/hpeds.2015-0069
  21. Aljfout Q, Alississ A, Rashdan H, et al. Antibiotics for post-tonsillectomy morbidity: comparative analysis of a single institutional experience. J Clin Med Res 2016;8:385-8. https://doi.org/10.14740/jocmr2523w
  22. Pfizer. Medication labeling information. Available from http://labeling.pfizer.com/ShowLabeling.aspx?format=PDF&id=512. Accessed April 27, 2016.