Background Prescriptions analysis and validation is one of the clinical pharmacist’s main tasks. In our pharmacy, one unit is dedicated solely to the validation of antibiotics and antifungal prescriptions from every hospital department. This often leads to pharmaceutical interventions (PI) defined as the process of a pharmacist identifying and making a recommendation in an attempt to prevent or resolve a drug-related problem.
Purpose To report the main prescription errors identified by PI and implement measures to avoid them.
Materials and methods Over 4 months, a pharmaceutical intervention sheet including the topics proposed by the French Society of Clinical Pharmacy was gone through for each pharmaceutical opinion.
Results During this study, 1058 prescriptions were assessed leading to 69 clinical pharmacist interventions (6.5%). 82% of them were accepted. 59% of the prescriptions were performed by a junior. PI underlined mainly inappropriate posology: underdosing (40%) and excessive doses (33%). The latter were mainly linked to a wrong adaptation for renal failure. Most frequent drugs were caspofungin (23%) (underdosing) and levofloxacin (21%) (unsuitable for impaired renal function).
PI also highlighted drug interactions especially between antifungals and ciclosporin (10%). Thus voriconazole was the drug third most selected in PI (20%). Other PI concerned non conformity to guidelines (10%) or inappropriate route of administration (3%). The 3 identified drugs are the main target of preventive measures.
Conclusions This study allowed us to identify the main prescription problems then we can establish improvements to prevent most errors. Preventive measures are to improve junior training, implement a ‘good practice guide to prescribing anti-infectives’, monitor patients treated by voriconazole and make doctors aware of medical interactions.
Pharmacists have a fundamental role in the medical process to improve health outcomes and patient safety. A clinical pharmacist trained on validation of anti-infective prescriptions is therefore essential.
No conflict of interest.
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