Klin Farmakol Farm. 2011;25(2):53-58

Prescription of antiinfectives in patients treated by immunosuppressive therapy

Jan Strojil, Vladimíra Vojtová, Pavel Anzenbacher

Ústav farmakologie, Lékařská fakulta Univerzity Palackého v Olomouci

Introduction and aim: Patients on immunosuppression have an increased risk of infections and therefore also antiinfective utilization.

Our aim was to characterize the differences between these patients and individual immunosuppressants.

Methods: We analyzed prescription in the University Hospital Olomouc between 2005 and 2010, a total of 191,313 patients (average age

42 years, 51 % women), of whom 2,229 (1.2 %) fulfilled the criterion of at least 180 days of immunosuppressive treatment.

Results: Patients on immunosuppressive treatment received 10 % of all antiinfective DDDs and over 30 % of the total cost of antiinfective

drugs. The structure of prescription was significantly different with markedly higher use of cotrimoxazole (29 vs. 7 %, p < 0.01)

and fluoroquinolones. Prescription of combinations was twice as common (18 % vs. 9 %, p < 0.01) and the combinations were different

(amoxicillin and cotrimoxazole being the most common). On the other hand, incidence of repeated prescriptions or switches was lower.

Itraconazole was the most prescribed antifungal and valgalciclovir dominated antiviral prescription. Transplanted patients on tacrolimus

received significantly more antiinfectives than those on ciclosporine (5.5 vs. 3.2 DDD/100 days, p < 0.01).

Conclusions: Prescription patterns vary based on indication and immunosuppressant. Many antiinfective drugs pose a potential drugdrug

interaction risk and should be prescribed with caution and rationally.

Keywords: immunosuppression, antiinfective agents, antibiotics, defined daily dose, cyclosporine, tacrolimus

Published: June 20, 2011  Show citation