Antiretroviral drug dosing errors in HIV-infected patients undergoing hemodialysis. Export

@article{citeulike:2087253, abstract = {BACKGROUND: Several studies have revealed the frequency of antiretroviral (ARV) drug prescription errors. We analyzed highly active antiretroviral therapy (HAART) prescribing practices for human immunodeficiency virus (HIV)-infected patients undergoing hemodialysis in France. METHODS: Prescribed ARV drug doses in our cohort (consisting of all HIV-infected patients who underwent hemodialysis from 1 January 2002 and were prospectively followed up until 1 January 2004) were compared with the recommended doses for patients undergoing hemodialysis. The log-rank test was used to compare the outcomes among different groups of treated patients. RESULTS: One hundred seven of the 129 patients in our cohort received a total of 317 ARV drugs, 59\% of which were improperly prescribed. The dosing was too low for 18\% of the patients and too high for 39\% of the patients. Twenty-eight patients (26\%) did not receive any of their ARV drugs at the recommended dose. The lowest prescribed dose (8\% of the daily recommended dose) was observed with indinavir and zidovudine, and the highest prescribed dose (1000\% of the recommended dose) was observed with stavudine. Among patients who received HAART, those who were prescribed an insufficient dose of a protease inhibitor had more-severe HIV disease and worse 2-year survival than did the other patients (mean rate of survival+/-standard deviation, 79.5\%+/-7.5\% vs. 95.4\%+/-2.6\%, respectively; P<.02). For dialyzable ARV drugs, the delay between ARV drug receipt by the patients and dialysis sessions was not respected in 9\% of cases, and in 73\% of cases, it was not known whether the patients took the ARV drugs before or after dialysis sessions. CONCLUSION: This is, to our knowledge, the first study to show a significant association between ARV drug prescription errors and survival in patients undergoing dialysis.}, address = {Nephrology Department, Groupe Hospitalier Piti\'{e}-Salp\^{e}tri\`{e}re, Paris, France. jtourret@yahoo.com}, author = {Tourret, J. and Tostivint, I. and T\'{e}zenas Du Montcel, S. and Karie, S. and Launay-Vacher, V. and Vigneau, C. and Bessette, C. and Deray, G. and Bagnis, C. I.}, citeulike-article-id = {2087253}, citeulike-linkout-0 = {http://dx.doi.org/10.1086/521168}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/17712764}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=17712764}, day = {15}, doi = {10.1086/521168}, issn = {1537-6591}, journal = {Clin Infect Dis}, keywords = {antiretroviral, ckd, hemodialysis, insufficiency, launay-vacher, renal}, month = {September}, number = {6}, pages = {779--784}, posted-at = {2007-12-11 00:14:16}, priority = {0}, title = {Antiretroviral drug dosing errors in HIV-infected patients undergoing hemodialysis.}, url = {http://dx.doi.org/10.1086/521168}, volume = {45}, year = {2007} }

TY - JOUR ID - citeulike:2087253 L3 - citeulike-article-id:2087253 N2 - BACKGROUND: Several studies have revealed the frequency of antiretroviral (ARV) drug prescription errors. We analyzed highly active antiretroviral therapy (HAART) prescribing practices for human immunodeficiency virus (HIV)-infected patients undergoing hemodialysis in France. METHODS: Prescribed ARV drug doses in our cohort (consisting of all HIV-infected patients who underwent hemodialysis from 1 January 2002 and were prospectively followed up until 1 January 2004) were compared with the recommended doses for patients undergoing hemodialysis. The log-rank test was used to compare the outcomes among different groups of treated patients. RESULTS: One hundred seven of the 129 patients in our cohort received a total of 317 ARV drugs, 59% of which were improperly prescribed. The dosing was too low for 18% of the patients and too high for 39% of the patients. Twenty-eight patients (26%) did not receive any of their ARV drugs at the recommended dose. The lowest prescribed dose (8% of the daily recommended dose) was observed with indinavir and zidovudine, and the highest prescribed dose (1000% of the recommended dose) was observed with stavudine. Among patients who received HAART, those who were prescribed an insufficient dose of a protease inhibitor had more-severe HIV disease and worse 2-year survival than did the other patients (mean rate of survival+/-standard deviation, 79.5%+/-7.5% vs. 95.4%+/-2.6%, respectively; P<.02). For dialyzable ARV drugs, the delay between ARV drug receipt by the patients and dialysis sessions was not respected in 9% of cases, and in 73% of cases, it was not known whether the patients took the ARV drugs before or after dialysis sessions. CONCLUSION: This is, to our knowledge, the first study to show a significant association between ARV drug prescription errors and survival in patients undergoing dialysis. IS - 6 JF - Clin Infect Dis SN - 1537-6591 AD - Nephrology Department, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. jtourret@yahoo.com EP - 784 TI - Antiretroviral drug dosing errors in HIV-infected patients undergoing hemodialysis. VL - 45 SP - 779 KW - antiretroviral KW - ckd KW - hemodialysis KW - insufficiency KW - launay-vacher KW - renal AU - Tourret, J AU - Tostivint, I AU - Tézenas Du Montcel, S AU - Karie, S AU - Launay-Vacher, V AU - Vigneau, C AU - Bessette, C AU - Deray, G AU - Bagnis, CI PY - 2007/09/15/ UR - http://dx.doi.org/10.1086/521168 ER -