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Improving antibacterial prescribing safety in the management of COPD exacerbations: systematic review of observational and clinical studies on potential drug interactions associated with frequently prescribed antibacterials among COPD patients
Wang, Y., Bahar, M. A., Jansen, A. M. E., Kocks, J. W. H., Alffenaar, J-W. C., Hak, E., Wilffert, B. & Borgsteede, S. D., Oct-2019, In : Journal of Antimicrobial Chemotherapy. 74, 10, p. 2848-2864 17 p.Research output: Contribution to journal › Article › Academic › peer-review
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Improving antibacterial prescribing safety in the management of COPD exacerbations : systematic review of observational and clinical studies on potential drug interactions associated with frequently prescribed antibacterials among COPD patients. / Wang, Yuanyuan; Bahar, Muh. Akbar; Jansen, Anouk M. E.; Kocks, Janwillem W. H.; Alffenaar, Jan-Willem C.; Hak, Eelko; Wilffert, Bob; Borgsteede, Sander D.
In: Journal of Antimicrobial Chemotherapy, Vol. 74, No. 10, 10.2019, p. 2848-2864.Research output: Contribution to journal › Article › Academic › peer-review
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TY - JOUR
T1 - Improving antibacterial prescribing safety in the management of COPD exacerbations
T2 - systematic review of observational and clinical studies on potential drug interactions associated with frequently prescribed antibacterials among COPD patients
AU - Wang, Yuanyuan
AU - Bahar, Muh. Akbar
AU - Jansen, Anouk M. E.
AU - Kocks, Janwillem W. H.
AU - Alffenaar, Jan-Willem C.
AU - Hak, Eelko
AU - Wilffert, Bob
AU - Borgsteede, Sander D.
PY - 2019/10
Y1 - 2019/10
N2 - BACKGROUND:Guidelines advise the use of antibacterials (ABs) in the management of COPD exacerbations. COPD patients often have multiple comorbidities, such as diabetes mellitus and cardiac diseases, leading to polypharmacy. Consequently, drug-drug interactions (DDIs) may frequently occur, and may cause serious adverse events and treatment failure.OBJECTIVES:(i) To review DDIs related to frequently prescribed ABs among COPD patients from observational and clinical studies. (ii) To improve AB prescribing safety in clinical practice by structuring DDIs according to comorbidities of COPD.METHODS:We conducted a systematic review by searching PubMed and Embase up to 8 February 2018 for clinical trials, cohort and case-control studies reporting DDIs of ABs used for COPD. Study design, subjects, sample size, pharmacological mechanism of DDI and effect of interaction were extracted. We evaluated levels of DDIs and quality of evidence according to established criteria and structured the data by possible comorbidities.RESULTS:In all, 318 articles were eligible for review, describing a wide range of drugs used for comorbidities and their potential DDIs with ABs. DDIs between ABs and co-administered drugs could be subdivided into: (i) co-administered drugs altering the pharmacokinetics of ABs; and (ii) ABs interfering with the pharmacokinetics of co-administered drugs. The DDIs could lead to therapeutic failures or toxicities.CONCLUSIONS:DDIs related to ABs with clinical significance may involve a wide range of indicated drugs to treat comorbidities in COPD. The evidence presented can support (computer-supported) decision-making by health practitioners when prescribing ABs during COPD exacerbations in the case of co-medication.
AB - BACKGROUND:Guidelines advise the use of antibacterials (ABs) in the management of COPD exacerbations. COPD patients often have multiple comorbidities, such as diabetes mellitus and cardiac diseases, leading to polypharmacy. Consequently, drug-drug interactions (DDIs) may frequently occur, and may cause serious adverse events and treatment failure.OBJECTIVES:(i) To review DDIs related to frequently prescribed ABs among COPD patients from observational and clinical studies. (ii) To improve AB prescribing safety in clinical practice by structuring DDIs according to comorbidities of COPD.METHODS:We conducted a systematic review by searching PubMed and Embase up to 8 February 2018 for clinical trials, cohort and case-control studies reporting DDIs of ABs used for COPD. Study design, subjects, sample size, pharmacological mechanism of DDI and effect of interaction were extracted. We evaluated levels of DDIs and quality of evidence according to established criteria and structured the data by possible comorbidities.RESULTS:In all, 318 articles were eligible for review, describing a wide range of drugs used for comorbidities and their potential DDIs with ABs. DDIs between ABs and co-administered drugs could be subdivided into: (i) co-administered drugs altering the pharmacokinetics of ABs; and (ii) ABs interfering with the pharmacokinetics of co-administered drugs. The DDIs could lead to therapeutic failures or toxicities.CONCLUSIONS:DDIs related to ABs with clinical significance may involve a wide range of indicated drugs to treat comorbidities in COPD. The evidence presented can support (computer-supported) decision-making by health practitioners when prescribing ABs during COPD exacerbations in the case of co-medication.
KW - chronic obstructive pulmonary disease
KW - drug interactions
KW - anti-bacterial agents
KW - safety
KW - acute exacerbation
U2 - 10.1093/jac/dkz221
DO - 10.1093/jac/dkz221
M3 - Article
VL - 74
SP - 2848
EP - 2864
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
SN - 0305-7453
IS - 10
ER -
ID: 84477080