scholarly journals Risk Factors and Characteristics of Adverse Reactions Associated with the Use of Beta-Lactam Antibiotics in Older Patients

2021 ◽  
Vol 9 (3) ◽  
pp. 128-135
Author(s):  
E. A. Sokova ◽  
V. V. Arkhipov ◽  
O. A. Demidova ◽  
I. A. Mazerkina ◽  
T. V. Alexandrova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Drug Reactions ◽  
Older Patients ◽  
Geriatric Patients ◽  
Scientific Literature ◽  
Community Acquired Pneumonia ◽  
Drug Reactions ◽  
Beta Lactam ◽  
Younger Patients ◽  
Beta Lactam Antibiotics

The frequency of adverse drug reactions (ADRs) in older patients is approximately 11.0%, according to scientific literature. Antibiotics are the third largest group (19.5%) of medicinal products in terms of ADR frequency in geriatric patients. Beta-lactam antibiotics are the empiric treatment of choice for older outpatients and inpatients with community-acquired pneumonia. The mortality in this group of patients accounts for 85% of the overall mortality from community-acquired pneumonia. The aim of the study was to analyse scientific data on risk factors and characteristics of adverse drug reactions associated with the use of beta-lactam antibiotics in older patients. Specificity of ADRs to beta-lactam antibiotics in this group of patients is due to age-related changes in pharmacokinetics and pharmacodynamics as well as polymorbidity and polypharmacy. The analysis of scientific literature demonstrated that there have not been so many pharmacoepidemiological studies in this group of patients, and their results have been inconsistent. The frequency, causes, and clinical manifestations of ADRs in geriatric patients are diverse and differ considerably from those in younger patients. Of the most widely used antibiotics, ceftriaxone and cefaclor exhibited a statistically lower risk of ADRs in older patients than in younger patients. At the same time, ceftriaxone was associated with a relatively higher frequency of serious ADRs in older patients as compared to younger patients, whereas the frequency of serious ADRs was lower with cefaclor. The likelihood of nephrotoxic, neurotoxic, and hepatotoxic ADRs associated with the use of beta-lactam antibiotics is becoming more and more obvious but it is still underestimated in clinical and geriatric practice. Safety monitoring, therapeutic drug monitoring with due consideration of ADR risk factors in older patients, and inclusion of older patients in clinical trials of antimicrobial drugs, would improve efficacy and safety of antibiotic treatment.

Active monitoring of adverse drug reactions to the use of beta-lactam antibiotics in the treatment of community-acquired pneumonia

2020 ◽  
Author(s):  
Ekaterina Sergeevna Torgunakova ◽  
Elena Nikolaevna Bochanova ◽  
Irina Vladimirovna Demko ◽  
Angelina Yur'Evna Kraposhina ◽  
Evgeniya Mikhailovna Kurts
Keyword(s):  
Adverse Drug Reactions ◽  
Community Acquired Pneumonia ◽  
Drug Reactions ◽  
Beta Lactam ◽  
Active Monitoring ◽  
Beta Lactam Antibiotics

scholarly journals Factors associated with acute myocardial infarction in older patients after hospitalization with community-acquired pneumonia: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yu Kang ◽  
Xiang-Yang Fang ◽  
Dong Wang ◽  
Xiao-Juan Wang
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Respiratory Failure ◽  
Hospital Mortality ◽  
Older Patients ◽  
Geriatric Patients ◽  
Community Acquired Pneumonia ◽  
Artery Disease

Abstract Background Community-acquired pneumonia (CAP) and acute myocardial infarction cardiovascular (AMI) are two important health issues in older patients. Little is known regarding characteristics of AMI in older patients hospitalized for CAP. Therefore, we investigated the prevalence, characteristics compared with younger patients, impact on clinical outcomes and risk factors of AMI during hospitalization for CAP in geriatric patients. Methods Eleven thousand nine adult inpatients consisted of 5111 patients≥65 years and 5898 patients< 65 years in respiratory ward diagnosed with CAP were retrospectively analyzed by electronic medical records. Results 159 (3.1%) older patients in respiratory ward experienced AMI during hospitalization for CAP. AMI were more frequently seen in patients≥65 years compared with patients< 65 years (3.1% vs. 1.0%). Patients≥65 years who experienced AMI during hospitalization for CAP had higher percentage of respiratory failure (P = 0.001), hypertension (P = 0.008), dyspnea (P = 0.046), blood urea nitrogen (BUN) ≥7 mmol/L (P < 0.001), serum sodium< 130 mmol/L (P = 0.005) and had higher in-hospital mortality compared to patients< 65 years (10.1% vs. 6.6%). AMI was associated with increased in-hospital mortality (odds ratio, OR, with 95% confidence interval: 1.49 [1.24–1.82]; P < 0.01). Respiratory failure (OR, 1.34 [1.15–1.54]; P < 0.01), preexisting coronary artery disease (OR, 1.31[1.07–1.59]; P = 0.02), diabetes (OR, 1.26 [1.11–1.42]; P = 0.02) and BUN (OR, 1.23 [1.01–1.49]; P = 0.04) were correlated with the occurrence of AMI in the older patients after hospitalization with CAP. Conclusions The incidence of AMI during CAP hospitalization in geriatric patients is notable and have an impact on in-hospital mortality. Respiratory failure, preexisting coronary artery disease, diabetes and BUN was associated with the occurrence of AMI in the older patients after hospitalization with CAP. Particular attention should be paid to older patients with risk factors for AMI.

scholarly journals Predictors of adverse drug reactions in geriatric patients: An exploratory study among cancer patients

2019 ◽  
Vol 08 (02) ◽  
pp. 130-133
Author(s):  
S. George Sneha ◽  
Kalpana Simhadri ◽  
Viswam K. Subeesh ◽  
S. Varghese Sneha
Keyword(s):  
Risk Factors ◽  
Adverse Drug Reactions ◽  
Geriatric Patients ◽  
Medical Oncology ◽  
Multivariate Logistic Regression Analysis ◽  
Drug Reactions ◽  
Chemotherapeutic Regimen ◽  
Potential Risk Factors ◽  
History Of ◽  
Independent Risk Factors

Abstract Objectives: The objective of this study was to study the predictors of adverse drug reactions (ADRs) among geriatric patients in the Department of Medical Oncology. Methods: A hospital-based prospective observational study was carried out among 153 inpatients in the Department of Medical Oncology for 6 months. Patients above 60 years of age with a confirmed history of malignancy were included in the study. The potential risk factors for ADR were defined in relation to the patient and chemotherapeutic regimen and relationship between them was assessed by univariate and multivariate logistic regression analysis. Results: Among 153 patients, 94 (64.43%) experienced ADRs. The mean ADR per patient was 0.88 ± 1.2. The common ADRs found were alopecia (30.18%) and diarrhea (28.68%). Risk estimates revealed that there was a significant association between smokers (odds ratio [OR] = 10.326; 95% confidence interval [CI] 2.345–45.47, P = 0.001), alcoholics (OR = 10.897; 95% CI 2.479–47.902, P = 0.001), increasing age (OR = 2.22; 95% CI 1.698–2.909, P = 0.001), overweight (OR = 16.68; 95% CI 2.179–127.741, P = 0.001), and male participants (OR = 0.143; 95% CI 0.05–0.390 P = 0.001) with the development of ADRs. The risk of carboplatin (OR = 13.359; 95% CI 3.056–58.406 P = 0.001) and 5-fluorouracil (OR = 1.938 95% CI 1.266–2.935 P = 0.001) use and occurrence of ADRs were also found to be high. Conclusion: The study findings showed that smoking, alcohol consumption, age more than 70 years, and overweight had a high risk for developing ADRs in geriatric patients who underwent chemotherapy. The independent risk factors identified should be targeted for preventive measures to improve anticancer agent prescription and reduce the risk of ADRs.

scholarly journals Delirium in geriatric patients

2022 ◽  
Author(s):  
Bernhard Iglseder ◽  
Thomas Frühwald ◽  
Christian Jagsch
Keyword(s):  
Risk Factors ◽  
Clinical Practice ◽  
Older Patients ◽  
Geriatric Patients ◽  
Pharmacological Intervention ◽  
Medical Complications ◽  
Medical Illness ◽  
Current Clinical Practice ◽  
Drug Reactions ◽  
Life Threatening

SummaryDelirium is the most common acute disorder of cognitive function in older patients. Delirium is life threatening, often under-recognized, serious, and costly. The causes are multifactorial, with old age and neurocognitive disorders as the main risk factors. Etiologies are various and multifactorial, and often related to acute medical illness, adverse drug reactions, or medical complications. To date, diagnosis is clinically based, depending on the presence or absence of certain features. In view of the multifactorial etiology, multicomponent approaches seem most promising for facing patients’ needs. Pharmacological intervention, neither for prevention nor for treatment, has been proven effective unanimously. This article reviews the current clinical practice for delirium in geriatric patients, including etiology, pathophysiology, diagnosis, prognosis, treatment, prevention, and outcomes.

scholarly journals Erratum: E. A. Sokova et al., Risk factors and characteristics of adverse reactions associated with the use of beta-lactam antibiotics in older patients

2021 ◽  
Vol 9 (4) ◽  
pp. 218
Author(s):  
Article Editorial
Keyword(s):  
Risk Factors ◽  
Older Patients ◽  
Adverse Reactions ◽  
Expert Evaluation ◽  
Publicly Funded ◽  
Medicinal Products ◽  
Beta Lactam ◽  
Public Accounting ◽  
Beta Lactam Antibiotics ◽  
Funded Research Project

Sоkоvа Е.А., Arkhipov V.V., Demidova O.A., Mazerkina I.A., Alexandrova T.V., Zhuravleva M.V. Risk factors and characteristics of adverse reactions associated with the use of beta-lactam antibiotics in older patients. Bezopasnost’ i risk farma koterapii = Safety and Risk of Pharmacotherapy. 2021;9(3):128–135. https://doi.org/10.30895/2312-7821-2021-9-3-128-135Dear readers, a technical error was made on page 134, issue 3 of the Safety and Risk of Pharmacotherapy, 2021 (2021;9(3):128–135). The following statement:“Acknowledgements. The study reported in this publication was carried out as part of a publicly funded research project No. 056-00005-21-00 and was supported by the Scientific Centre for Expert Evaluation of Medicinal Products (R&D public accounting No. 121021800098-4)”should read:“Acknowledgements. The study reported in this publication was carried out as part of a publicly funded research project No. 056-00005-21-00 and was supported by the Scientific Centre for Expert Evaluation of Medicinal Products (R&D public accounting No. 121022000154-2)”.The correction did not have any effect on the conclusions made by the authors.The text of the online version of the journal was corrected accordingly.

Characteristics, outcomes, and risk factors of ICANS after axicabtagene ciloleucel: Does age matter?

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19556-e19556
Author(s):  
Kitsada Wudhikarn ◽  
Radhika Bansal ◽  
Arushi Khurana ◽  
Matthew Hathcock ◽  
Michael Ruff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Older Patients ◽  
Clinical Course ◽  
International Prognostic Index ◽  
Age Groups ◽  
Central Nervous System Involvement ◽  
Microvascular Disease ◽  
B Cell Lymphoma ◽  
Younger Patients

e19556 Background: CD19 chimeric antigen receptor T cell therapy possesses unique side effects including cytokine release syndrome (CRS) and immune effector cell associated neurotoxicity syndrome (ICANS). Age is a major risk factor for ICANS. However, whether ICANS in older patients is different compared to younger patients is unknown. Herein, we report clinical course, outcomes and risk factors for ICANS in older patients with large B cell lymphoma (LBCL) treated with axicabtagene ciloleucel (axi-cel). Methods: We comprehensively reviewed detailed clinical courses of ICANS in 78 adult patients with LBCL treated with axi-cel between June 2016 and October 2020. Incidence, manifestation, risk factors, treatment, and outcomes of ICANS were compared between patients age ≥60 (n=32) and <60 (n=46) years old. Results: Baseline characteristics were comparable between older and younger patients except higher proportion of high international prognostic index and underlying cerebral microvascular disease in older patients. ICANS was observed in 16 patients in the older and 24 patients in the younger age group, with a 30-day incidence of 52% and 50%, respectively. Median time to CRS and ICANS were similar between 2 age groups. The most common initial neurological findings included aphasia, dysgraphia and encephalopathy in both age groups. Table summarizes the characteristics, clinical course and interventions of ICANS in older and younger patients. In Cox regression model, the presence of CRS was the only factor associated with ICANS in both age groups. Age, history of central nervous system involvement and cerebral microvascular disease were not associated with ICANS. Importantly, all patients had complete resolution of ICANS. No elderly patients in our cohort experienced seizure as a manifestation of ICANS. Conclusions: In our study, older age was not a risk factor for ICANS. CRS was the only factor associated with ICANS in both younger and older patients. Incidence, clinical course and neurological outcomes of ICANS in older patients treated with axi-cel were comparable to younger patients. [Table: see text]

scholarly journals Cutaneous adverse drug reactions to psychotropic drugs and their risk factors – a case-control study

2019 ◽  
Vol 29 (1) ◽  
pp. 111-121 ◽  
Author(s):  
Waldemar Greil ◽  
Xueqiong Zhang ◽  
Hans Stassen ◽  
Renate Grohmann ◽  
René Bridler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Drug Reactions ◽  
Psychotropic Drugs ◽  
Case Control Study ◽  
Case Control ◽  
Drug Reactions ◽  
Control Study
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