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Reduce Adverse Drug Events Involving Antibiotics

Some potent antibiotics, while very effective against certain types of infections, have a high risk for toxicity. This risk is even greater with patients who have impaired renal function. When using antibiotics that have a high risk of toxicity, such as aminoglycosides and vancomycin, use protocols or other standardized dosing guidelines to assist prescribers in selecting appropriate doses based on clinical condition and renal function.

Changes for Improvement

Design Protocols for Dose Administration Once Daily
In order to minimize the risk of toxicity with antibiotics, especially aminoglycosides and vancomycin, use once-per-day dosing regimens if appropriate based on the patient’s clinical condition. Incorporate the once-per-day schedule into dosing protocols, which can be helpful tools for prescribers and clinical staff.

Tips

Use protocols with vancomycin and aminoglycosides.
Ensure that laboratory information is readily available to pharmacists, prescribers, or whoever will be ordering and adjusting vancomycin doses.
Permit pharmacists to adjust doses for all renal patients.
Make pharmacy consultation automatic for use of these antibiotics and for renal patients.
Provide results of renal function studies on screen when using computerized prescriber order entry systems.

Use Protocols with Vancomycin and Aminoglycosides
Vancomycin and aminoglycosides are potent antibiotics with a high risk of toxicity, especially in patients with impaired renal function. A protocol can provide a guide for clinical personnel to select the appropriate dosage quickly and accurately depending on whether renal function is normal or impaired. Pharmacists can initiate and manage these protocols, which saves time for staff and physicians. What is more important is the fact that protocols can guide dosage adjustments based on renal function studies and serum drug concentrations. Allowing pharmacists to use protocols also helps make adjustments to dosages more timely, which helps decrease the risk of adverse drug events to patients.

Tips

Ensure that laboratory information is readily available to pharmacists, prescribers, or whoever will be ordering and adjusting vancomycin doses.
Permit pharmacists to adjust doses for all renal patients.
Make pharmacy consultation automatic for use of these antibiotics and for renal patients.
Provide results of renal function studies on screen when using computerized prescriber order entry systems.

Reduce Adverse Drug Events Involving Anticoagulants
Careful monitoring and management of anticoagulant medications can help prevent harm from over-coagulation or under-coagulation.
Reduce Adverse Drug Events Involving Chemotherapy
Use extra safety measures with chemotherapy medications to prevent adverse drug events (ADEs), which can be extremely serious due to the toxicity of these drugs.
Reduce Adverse Drug Events Involving Electrolytes
Use standardized approaches and forcing functions to prevent errors related to electrolyte administration that can lead to serious adverse drug events (ADEs).
Reduce Adverse Drug Events Involving Insulin
Coordinate care processes and use standardized tools when caring for patients on insulin to reduce the risk of adverse drug events (ADEs).
Reduce Adverse Drug Events Involving Intravenous Medications
Using known safe practices with intravenous medications and equipment can help reduce their risk of adverse drug events (ADEs).
Reduce Adverse Drug Events Involving Narcotics and Sedatives
Careful monitoring and management of narcotics and sedatives can help prevent harm, especially from overdoses.

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