Polypharmacy in managment of in-patients with novel coronavirus disease (COVID-19)

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Abstract

The aim. To identify polypharmacy cases and develop the ways to optimize pharmacotherapy of patients with COVID-19 hospitalized in infectious disease facilities.

Materials and methods. ATC/DDD analysis with calculation of DDDs/100 bed days and a sample analysis of 500 patients’ prescriptions were performed for presenting drug utilization statistics in the infectious disease facilities of Volgograd region, which had been reassigned to treat patients with COVID-19 in 2020 and 2021.

Results. Five or more drugs were administered simultaneously in 96.8% of patients. Antibacterial drugs were in 74.3% of the analyzed prescriptions in 2020 and in 73.5% in 2021. The total consumption of antibiotics was 102.9 DDDs/100 bed-days in 2020 and 95.7 DDDs/100 bed-days in 2021. The cases of multiple administrations of biological disease modifying antirheumatic drugs and the use of cyclophosphamide have been identified. In 73.6% of prescriptions in 2020 and 85.4% of 2021, omeprazole at the dose of 40 mg per day was used (77.3 and 84.6 DDDs/100 bed-days, respectively). In 2021, there were cases of concomitant intravenous prescribing of acetylcysteine under the trade name of Fluimucil® with tableted forms of ambroxol and acetylcysteine under the name of ACC®. The cumulative consumption of hepatotoxic drugs was 269.2 DDDs/100 bed-days in 2020 and 401.5 DDDs/100 bed-days in 2021.

Conclusion. Lack of drugs with proven effectiveness for treatment of COVID-19, worked-out treatment algorithms, a high mortality of patients in the hospitals led to polypragmasy, excessive prescribing of drugs in the hospitals. The prescription of antibacterial drugs, omeprazole, mucolytics, hepatotoxic drugs, immunosuppressors in infectious hospitals should be monitored by clinical pharmacologist.

About the authors

Vladimir I. Petrov

Volgograd State Medical University

Author for correspondence.
Email: brain@sprintnet.ru
ORCID iD: 0000-0002-0258-4092

Doctor of Sciences (Medicine), Professor, Academician of the Russian Academy of Sciences, Head of the Department of Clinical Pharmacology and Intensive Care, Volgograd State Medical University, Chief Freelance Specialist – Clinical Pharmacologist of the Ministry of Health of the Russian Federation, Honored Scientist of the Russian Federation, Honored Doctor of the Russian Federation

Russian Federation, 1, Pavshikh Bortsov Sq., Volgograd, 400131

Anastasia Y. Ryazanova

Volgograd State Medical University

Email: nastasyakus@mail.ru
ORCID iD: 0000-0002-4778-5015

Candidate of Sciences (Medicine), Associate Professor of the Department of Clinical Pharmacology, Intensive Care, Volgograd State Medical University

Russian Federation, 1, Pavshikh Bortsov Sq., Volgograd, 400131

Natalia S. Privaltseva

Volgograd State Medical University

Email: nata5847@yandex.ru
ORCID iD: 0000-0002-2578-6228

Postgraduate student, Department of Clinical Pharmacology and Intensive Care, Volgograd State Medical University

Russian Federation, 1, Pavshikh Bortsov Sq., Volgograd, 400131

Dmitry A. Nekrasov

Volgograd State Medical University

Email: dmitiynekrasov@mail.ru
ORCID iD: 0000-0002-1722-011X

Postgraduate student, Department of Clinical Pharmacology and Intensive Care, Volgograd State Medical University

Russian Federation, 1, Pavshikh Bortsov Sq., Volgograd, 400131

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Supplementary files

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2. Figure 1 - Structure and volume of consumption of the most commonly used drugs and groups of drugs in patients with COVID-19

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3. Figure 2 - Structure and volume of consumption of antibacterial drugs in patients with COVID-19

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4. Figure 3 - Structure and volume of consumption of hepatotoxic drugs in patients with COVID-19

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5. Figure 1 – Structure and volume of consumption of the most commonly used drugs and groups of drugs in patients with COVID-19

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6. Figure 2 – Structure and volume of antibacterial drugs consumption in patients with COVID-19

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7. Figure 3 – Structure and volume of hepatotoxic drugs consumption in patients with COVID-19

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Copyright (c) 2022 Petrov V.I., Ryazanova A.Y., Privaltseva N.S., Nekrasov D.A.

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