2020년 Vol.37 No.02
Background : Despite recent advances in diagnosis and treatment, pneumonia causes great morbidity and mortality and entails high healthcare costs. Levofloxacin is one of the recommended drugs for the treatment of pneumonia. However, the increase in the use of levofloxacin may lead to an increase in resistance to this medication. The purpose of this study was to evaluate the rate of levofloxacin use to prevent resistance to the drug as per the developed criteria (referenced with Micromedex®, KIMS® and KFDA) and to provide information for implementation of pharmaceutical intervention for the optimal intravenous-to-oral (IV-to-PO) switch.
Methods : This study was conducted within pneumonia patients discharged from the pulmonology ward at the Ulsan University Hospital June 1, December 31, 2018. The evaluation criteria were as follow: treatment dose, duration of the treatment, potential drug-drug interactions (pDDIs), evaluation of implementation of essential examinations and adverse drug reaction (ADR) monitoring, and the optimal IV-to-PO switch. The electronic medical record (EMR) database
was used to retrospectively collect data.
Results : In total, 125 patients were included, of whom 17 were later excluded from the evaluation
of the treatment period, and optimal IV-to-PO switch from death during the treatment.
Dose adjustment according to renal function was required in 59 (47.2%) patients, four of whom
received a suitable dose. The treatment period was appropriate in 66.7% patients. Also, 34.4%
patients did not receive concomitant drugs that could interact with levofloxacin, and the implementation rate of essential examination was high except for therapeutic drug monitoring.
Additionally, 46.3% of patients were suitable for the optimal IV-to-PO switch. Although no
ADRs were reported during ADR monitoring, several symptoms including itching, and elevated
LFT were recorded by the EMR.
Conclusion : Through evaluating of use of levofloxacin in pneumonia patients, we confirmed
that practical mediation by pharmacists and improvement of the system are necessary.