Judicious Use of Benzathine Penicillin G in Response to a Medication Alert During a Critical Drug Shortage.

IF 1.1 Q4 PHARMACOLOGY & PHARMACY Journal of Pharmacy Technology Pub Date : 2024-10-11 DOI:10.1177/87551225241285317

William Campillo Terrazas, Rachel M Kenney, Amy Argyris, Anita B Shallal, Michael P Veve

{"title":"Judicious Use of Benzathine Penicillin G in Response to a Medication Alert During a Critical Drug Shortage.","authors":"William Campillo Terrazas, Rachel M Kenney, Amy Argyris, Anita B Shallal, Michael P Veve","doi":"10.1177/87551225241285317","DOIUrl":null,"url":null,"abstract":"Purpose: To evaluate judicious antibiotic prescribing of benzathine penicillin G (BPG) after implementation of an electronic health record-based medication shortage alert during a critical drug shortage.Methods: This was an institutional review board-approved retrospective cohort study of patients aged ≥3 months who received BPG between May 9, 2023, and February 28, 2024. The study included inpatient and outpatient visits after implementing a BPG medication shortage alert; patients with severe penicillin allergy, neurosyphilis, or congenital syphilis were excluded. Judicious BPG use was defined as use in patients diagnosed with primary, secondary, or latent syphilis or if they were prescribed a BPG alternative in response to the medication shortage alert; nonjudicious use included BPG for alternative diagnoses. Social determinants of health were assessed as exposure variables of interest. A separate cohort of syphilis patients receiving BPG or alternative therapy (i.e., doxycycline) was described.Results: A total of 453 patients were included. Most patients were non-Hispanic Black (n = 273, 60%) men (n = 272, 60%) with a median (interquartile range) age of 32 (22-44) years. Of these, 318 (70%) received judicious BPG, whereas 135 (30%) received nonjudicious BPG. The most nonjudicious diagnosis was streptococcal pharyngitis (n = 128, 95%). Variables associated with judicious use included age >32 years (adjusted odds ratio [adjOR], 2.273; 95% CI, 1.488-3.472), male sex (adjOR, 1.835; 95% CI, 1.206-2.792), and black race (adjOR, 1.847; 95% CI, 1.212-2.815). Among a cohort of 128 syphilis patients who received BPG (n = 64, 50%) or doxycycline (n = 64, 50%), those who received doxycycline were more likely be uninsured (35 [54.7%] vs 43 [67.2%]; P = .15) and receive outpatient treatment (3 [4.7%] vs 12 [18.7%]; P = .13).Conclusion: Despite implementing an electronic health record drug shortage alert, 30% of BPG use was nonjudicious and mostly for pharyngitis.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"87551225241285317"},"PeriodicalIF":1.1000,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559713/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pharmacy Technology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/87551225241285317","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: To evaluate judicious antibiotic prescribing of benzathine penicillin G (BPG) after implementation of an electronic health record-based medication shortage alert during a critical drug shortage.

Methods: This was an institutional review board-approved retrospective cohort study of patients aged ≥3 months who received BPG between May 9, 2023, and February 28, 2024. The study included inpatient and outpatient visits after implementing a BPG medication shortage alert; patients with severe penicillin allergy, neurosyphilis, or congenital syphilis were excluded. Judicious BPG use was defined as use in patients diagnosed with primary, secondary, or latent syphilis or if they were prescribed a BPG alternative in response to the medication shortage alert; nonjudicious use included BPG for alternative diagnoses. Social determinants of health were assessed as exposure variables of interest. A separate cohort of syphilis patients receiving BPG or alternative therapy (i.e., doxycycline) was described.

Results: A total of 453 patients were included. Most patients were non-Hispanic Black (n = 273, 60%) men (n = 272, 60%) with a median (interquartile range) age of 32 (22-44) years. Of these, 318 (70%) received judicious BPG, whereas 135 (30%) received nonjudicious BPG. The most nonjudicious diagnosis was streptococcal pharyngitis (n = 128, 95%). Variables associated with judicious use included age >32 years (adjusted odds ratio [adjOR], 2.273; 95% CI, 1.488-3.472), male sex (adjOR, 1.835; 95% CI, 1.206-2.792), and black race (adjOR, 1.847; 95% CI, 1.212-2.815). Among a cohort of 128 syphilis patients who received BPG (n = 64, 50%) or doxycycline (n = 64, 50%), those who received doxycycline were more likely be uninsured (35 [54.7%] vs 43 [67.2%]; P = .15) and receive outpatient treatment (3 [4.7%] vs 12 [18.7%]; P = .13).

Conclusion: Despite implementing an electronic health record drug shortage alert, 30% of BPG use was nonjudicious and mostly for pharyngitis.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

在药物严重短缺期间，根据用药警报明智使用苄星青霉素 G。

目的：评估在严重药物短缺期间实施基于电子健康记录的药物短缺警报后苄星青霉素 G（BPG）抗生素处方的合理性：这是一项经机构审查委员会批准的回顾性队列研究，研究对象是 2023 年 5 月 9 日至 2024 年 2 月 28 日期间接受苄星青霉素 G 治疗的年龄≥3 个月的患者。研究包括实施 BPG 药物短缺警报后的住院和门诊就诊情况；排除了严重青霉素过敏、神经梅毒或先天性梅毒患者。诊断为原发性、继发性或潜伏梅毒的患者，或根据药物短缺警报开具了 BPG 替代处方的患者，均被定义为慎用 BPG；非慎用 BPG 包括用于其他诊断的 BPG。健康的社会决定因素被评估为相关的暴露变量。此外，还对接受 BPG 或替代疗法（即强力霉素）的梅毒患者进行了单独分组：共纳入 453 名患者。大多数患者为非西班牙裔黑人（n = 273，60%），男性（n = 272，60%），中位数（四分位数间距）年龄为 32（22-44）岁。其中，318 人（70%）接受了明智的 BPG，135 人（30%）接受了非明智的 BPG。最常见的非判断性诊断是链球菌性咽炎（128 人，95%）。与判断性使用相关的变量包括：年龄大于 32 岁（调整赔率 [adjOR]，2.273；95% CI，1.488-3.472）、男性（adjOR，1.835；95% CI，1.206-2.792）和黑人（adjOR，1.847；95% CI，1.212-2.815）。在接受 BPG（64 人，50%）或强力霉素（64 人，50%）治疗的 128 名梅毒患者中，接受强力霉素治疗的患者更有可能没有保险（35 [54.7%] vs 43 [67.2%]；P = .15），并且更有可能接受门诊治疗（3 [4.7%] vs 12 [18.7%]；P = .13）：结论：尽管实施了电子健康记录药物短缺预警，但仍有 30% 的 BPG 使用是非判断性的，且主要用于治疗咽炎。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of Pharmacy Technology PHARMACOLOGY & PHARMACY-

CiteScore

1.50

自引率

0.00%

发文量

期刊介绍： For both pharmacists and technicians, jPT provides valuable information for those interested in the entire body of pharmacy practice. jPT covers new drugs, products, and equipment; therapeutic trends; organizational, legal, and educational activities; drug distribution and administration; and includes continuing education articles.