Leftover of Amoxicillin Suspension After Use by Children in the Netherlands.

IF 2.4 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pharmacoepidemiology and Drug Safety Pub Date : 2024-08-01 DOI:10.1002/pds.5868
Milad Sadreghaemy, Magdalena A Gamba, Lourens T Bloem, Toine C G Egberts
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Abstract

Purpose: In clinical practice, a discrepancy may exist between the prescribed amount of a drug and the commercially available pack sizes in the pharmacy, potentially contributing to drug waste. This study aimed-as an example of this phenomena-to quantify leftover of amoxicillin suspension prescribed to children, due to discrepancies between physician-prescribed and pharmacy-dispensed amounts.

Methods: We performed a retrospective cohort study including amoxicillin suspension dispensations for patients aged 0-12 years between 2017 and 2019 utilizing the Dutch PHARMO database. Leftover amount of amoxicillin was estimated by assessing the discrepancy between the prescribed and dispensed amounts. Extrapolated amoxicillin weight and economic spillage estimates for the Netherlands were determined. The impact of two theoretical interventions on leftover amount was assessed: (1) introducing vials with half the volume of the current 100 and 30 mL vials and (2) a combination of the first intervention with a maximum of 10% round-down by the dispensing pharmacy of the prescribed dose.

Results: We included 79 512 amoxicillin suspension dispensations for 62 252 patients. The mean leftover amount of amoxicillin suspension per dispensing was 27%. The yearly amount of amoxicillin leftover was 49.8 kg in the study cohort, equivalent to yearly 633 kg and €621 000 when extrapolated to the Netherlands. Employing the first theoretical intervention reduced the mean leftover per dispensing to 20%, reducing the yearly leftover to 31.6 kg amoxicillin in the study cohort, and to 400 kg and €400 000 extrapolated. The second theoretical intervention further reduced leftover to 17%, reducing the yearly leftover to 24.3 kg amoxicillin in the study cohort, and to 300 kg and €300 000 extrapolated.

Conclusion: Approximately a quarter of amoxicillin suspension remains as leftover per dispensing. Applying different theoretical intervention shows the potential for a significant reduction of amoxicillin leftover.

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荷兰儿童使用阿莫西林混悬液后的残留物。
目的:在临床实践中,处方药量与药房的市售包装规格之间可能存在差异,从而可能造成药物浪费。本研究旨在以这一现象为例,量化因医生处方量与药房配药量不一致而造成的儿童阿莫西林混悬液的剩余量:我们利用荷兰 PHARMO 数据库开展了一项回顾性队列研究,其中包括 2017 年至 2019 年期间 0-12 岁患者的阿莫西林混悬液配药情况。通过评估处方量和配药量之间的差异,估算出阿莫西林的剩余量。确定了荷兰阿莫西林的推断重量和经济溢出估计值。评估了两种理论干预措施对残留量的影响:(1) 引入容积为目前 100 毫升和 30 毫升小瓶一半的小瓶;(2) 将第一种干预措施与发药药房最多将处方剂量四舍五入 10%的措施相结合:结果:我们纳入了 62 252 名患者的 79 512 次阿莫西林混悬液配药。每次配药的阿莫西林混悬液平均剩余量为 27%。研究队列中每年阿莫西林的剩余量为 49.8 千克,推算到荷兰,相当于每年 633 千克和 621 000 欧元。采用第一种理论干预措施可将每次配药的平均剩余量减少到 20%,从而将研究队列中的阿莫西林年剩余量减少到 31.6 公斤,推算出的年剩余量为 400 公斤和 400 000 欧元。第二次理论干预进一步将剩余量减少到 17%,将研究队列中的阿莫西林年剩余量减少到 24.3 千克,推断为 300 千克和 300 000 欧元:结论:每次配药时,大约有四分之一的阿莫西林混悬液被剩余。采用不同的理论干预措施可显著减少阿莫西林的残留量。
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来源期刊
CiteScore
4.80
自引率
7.70%
发文量
173
审稿时长
3 months
期刊介绍: The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.
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