Potentially inappropriate prescriptions of antibiotics in geriatric psychiatry—a retrospective cohort study
IntroductionOlder patients are frequently affected by infectious diseases and adverse drug reactions (ADRs) of consecutively prescribed antibiotics. Particularly within geriatric psychiatry, high rates of potentially inappropriate prescriptions (PIPs) have been described, significantly complicating...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-01-01
|
| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1272695/full |
| _version_ | 1827386840080973824 |
|---|---|
| author | Tabea Pfister Sebastian Schröder Johannes Heck Stefan Bleich Tillmann H. C. Krüger Felix Wedegärtner Adrian Groh Martin Schulze Westhoff |
| author_facet | Tabea Pfister Sebastian Schröder Johannes Heck Stefan Bleich Tillmann H. C. Krüger Felix Wedegärtner Adrian Groh Martin Schulze Westhoff |
| author_sort | Tabea Pfister |
| collection | DOAJ |
| description | IntroductionOlder patients are frequently affected by infectious diseases and adverse drug reactions (ADRs) of consecutively prescribed antibiotics. Particularly within geriatric psychiatry, high rates of potentially inappropriate prescriptions (PIPs) have been described, significantly complicating pharmacological treatment. Therefore, this study aimed to investigate the frequency and characteristics of antibiotic PIPs in geriatric psychiatry.MethodsMedication charts of 139 patient cases (mean age 78.8 years; 69.8% female) receiving antibiotic treatment on a geriatric psychiatric ward were analyzed. Utilizing previously published definitions of antibiotic PIPs, adequacy of the antibiotic prescriptions was subsequently assessed.Results16.3% of all screened patient cases (139/851) received an antibiotic treatment during their inpatient stay. 59.5% of antibiotic prescriptions were due to urinary tract infections, followed by pulmonary (13.3%) and skin and soft tissue infections (11.3%). 46.7% of all antibiotic prescriptions fulfilled at least one PIP criterium, with the prescription of an antibiotic course for more than seven days as the most common PIP (15.3%).DiscussionAntibiotic PIPs can be considered as a frequent phenomenon in geriatric psychiatry. Especially the use of fluoroquinolones and cephalosporins should be discussed critically due to their extensive side effect profiles. Due to the special characteristics of geriatric psychiatric patients, international guidelines on the use of antibiotics should consider frailty and psychotropic polypharmacy of this patient population more closely. |
| first_indexed | 2024-03-08T15:52:25Z |
| format | Article |
| id | doaj.art-248141d4d06a4736b524f679261a810b |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-03-08T15:52:25Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-248141d4d06a4736b524f679261a810b2024-01-09T04:23:49ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402024-01-011410.3389/fpsyt.2023.12726951272695Potentially inappropriate prescriptions of antibiotics in geriatric psychiatry—a retrospective cohort studyTabea Pfister0Sebastian Schröder1Johannes Heck2Stefan Bleich3Tillmann H. C. Krüger4Felix Wedegärtner5Adrian Groh6Martin Schulze Westhoff7Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, GermanyDepartment of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, GermanyInstitute for Clinical Pharmacology, Hannover Medical School, Hannover, GermanyDepartment of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, GermanyDepartment of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, GermanyDepartment of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, GermanyDepartment of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, GermanyDepartment of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, GermanyIntroductionOlder patients are frequently affected by infectious diseases and adverse drug reactions (ADRs) of consecutively prescribed antibiotics. Particularly within geriatric psychiatry, high rates of potentially inappropriate prescriptions (PIPs) have been described, significantly complicating pharmacological treatment. Therefore, this study aimed to investigate the frequency and characteristics of antibiotic PIPs in geriatric psychiatry.MethodsMedication charts of 139 patient cases (mean age 78.8 years; 69.8% female) receiving antibiotic treatment on a geriatric psychiatric ward were analyzed. Utilizing previously published definitions of antibiotic PIPs, adequacy of the antibiotic prescriptions was subsequently assessed.Results16.3% of all screened patient cases (139/851) received an antibiotic treatment during their inpatient stay. 59.5% of antibiotic prescriptions were due to urinary tract infections, followed by pulmonary (13.3%) and skin and soft tissue infections (11.3%). 46.7% of all antibiotic prescriptions fulfilled at least one PIP criterium, with the prescription of an antibiotic course for more than seven days as the most common PIP (15.3%).DiscussionAntibiotic PIPs can be considered as a frequent phenomenon in geriatric psychiatry. Especially the use of fluoroquinolones and cephalosporins should be discussed critically due to their extensive side effect profiles. Due to the special characteristics of geriatric psychiatric patients, international guidelines on the use of antibiotics should consider frailty and psychotropic polypharmacy of this patient population more closely.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1272695/fullgeriatric psychiatrydrug safetypotentially inappropriate medicationsantibioticsantibiotic stewardship |
| spellingShingle | Tabea Pfister Sebastian Schröder Johannes Heck Stefan Bleich Tillmann H. C. Krüger Felix Wedegärtner Adrian Groh Martin Schulze Westhoff Potentially inappropriate prescriptions of antibiotics in geriatric psychiatry—a retrospective cohort study Frontiers in Psychiatry geriatric psychiatry drug safety potentially inappropriate medications antibiotics antibiotic stewardship |
| title | Potentially inappropriate prescriptions of antibiotics in geriatric psychiatry—a retrospective cohort study |
| title_full | Potentially inappropriate prescriptions of antibiotics in geriatric psychiatry—a retrospective cohort study |
| title_fullStr | Potentially inappropriate prescriptions of antibiotics in geriatric psychiatry—a retrospective cohort study |
| title_full_unstemmed | Potentially inappropriate prescriptions of antibiotics in geriatric psychiatry—a retrospective cohort study |
| title_short | Potentially inappropriate prescriptions of antibiotics in geriatric psychiatry—a retrospective cohort study |
| title_sort | potentially inappropriate prescriptions of antibiotics in geriatric psychiatry a retrospective cohort study |
| topic | geriatric psychiatry drug safety potentially inappropriate medications antibiotics antibiotic stewardship |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1272695/full |
| work_keys_str_mv | AT tabeapfister potentiallyinappropriateprescriptionsofantibioticsingeriatricpsychiatryaretrospectivecohortstudy AT sebastianschroder potentiallyinappropriateprescriptionsofantibioticsingeriatricpsychiatryaretrospectivecohortstudy AT johannesheck potentiallyinappropriateprescriptionsofantibioticsingeriatricpsychiatryaretrospectivecohortstudy AT stefanbleich potentiallyinappropriateprescriptionsofantibioticsingeriatricpsychiatryaretrospectivecohortstudy AT tillmannhckruger potentiallyinappropriateprescriptionsofantibioticsingeriatricpsychiatryaretrospectivecohortstudy AT felixwedegartner potentiallyinappropriateprescriptionsofantibioticsingeriatricpsychiatryaretrospectivecohortstudy AT adriangroh potentiallyinappropriateprescriptionsofantibioticsingeriatricpsychiatryaretrospectivecohortstudy AT martinschulzewesthoff potentiallyinappropriateprescriptionsofantibioticsingeriatricpsychiatryaretrospectivecohortstudy |