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Al-Dorzi HM, Eissa AT, Khan RM, et al. Dosing errors of empirical antibiotics in critically ill patients with severe sepsis or septic shock: A prospective observational study. Int J Health Sci (Qassim). 2019;13(4):48-55
Al-Dorzi, H. M., Eissa, A. T., Khan, R. M., Harbi, S. A. A., Aldabbagh, T., & Arabi, Y. M. (2019). Dosing errors of empirical antibiotics in critically ill patients with severe sepsis or septic shock: A prospective observational study. International journal of health sciences, 13(4), 48-55.
Al-Dorzi, Hasan M, et al. "Dosing errors of empirical antibiotics in critically ill patients with severe sepsis or septic shock: A prospective observational study." International journal of health sciences vol. 13,4 (2019): 48-55.
Al-Dorzi HM, Eissa AT, Khan RM, Harbi SAA, Aldabbagh T, Arabi YM. Dosing errors of empirical antibiotics in critically ill patients with severe sepsis or septic shock: A prospective observational study. Int J Health Sci (Qassim). 2019 Jul-Aug;13(4):48-55. PMID: 31341455; PMCID: PMC6619455.
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Int J Health Sci (Qassim). 2019 Jul-Aug;13(4):48-55.

Dosing errors of empirical antibiotics in critically ill patients with severe sepsis or septic shock: A prospective observational study.

International journal of health sciences

Hasan M Al-Dorzi, Abdullah T Eissa, Raymond M Khan, Shmeylan A Al Harbi, Tarek Aldabbagh, Yaseen M Arabi

Affiliations

  1. Department of Intensive Care, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.
  2. King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
  3. College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
  4. Department of Surgery, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.
  5. Department of Pharmaceutical Care, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.

PMID: 31341455 PMCID: PMC6619455

Abstract

BACKGROUND: Effective antibiotic therapy is crucial in sepsis management. Studies have emphasized on antibiotic administration timing more than dosing. We evaluated the frequency and risk factors of antibiotic dosing errors in sepsis.

MATERIALS AND METHODS: This prospective observational study compared the doses of intravenous empirical antibiotics in the 1

RESULTS: Between October 1, 2013, and April 30, 2014, 189 patients were evaluated (age 61.6 ± 18.6 years, acute physiology and chronic health evaluation II score 22.8 ± 7.0, 58.7% septic shock) with 415 antibiotic prescriptions (2.2 ± 0.9 prescriptions per patient). Antibiotic dosing was appropriate in 50.8% of patients; under-dosing in 30.7% and overdosing in 25.9%. Under-dosing prevalence was 39.4% when kidney function was assessed by the Cockcroft-Gault equation. Vancomycin was associated with the highest under-dosing rate (39.4%), followed by piperacillin/tazobactam (12.1%). The cohort mortality was 35.4%. Age, shock, chronic kidney disease, and cirrhosis independently predicted mortality on multivariable logistic regression analysis. Antibiotic dosing error was not associated with mortality: Over-versus appropriate dosing (odds ratio [OR], 1.41; 95% confidence interval [CI], 0.57-3.47), under-versus appropriate dosing (OR, 0.57; 95% CI, 0.24-1.35).

CONCLUSIONS: Antibiotic dosing errors were common in patients with sepsis. Vancomycin had the highest under-dosing rate. Antibiotic dosing errors were not associated with increased mortality.

Keywords: Antimicrobial; critical care; dose; medication error; sepsis

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