Antimicrobial drug administration errors identified in Brazilian multicentric study

Erros de administração de antimicrobianos são relevantes, pois podem interferir na segurança do paciente e no desenvolvimento de resistência microbiana. O objetivo desse estudo foi identificar os antimicrobianos associados a erros de administração de medicamentos. Estudo multicêntrico, descritivo e exploratório, realizado em unidades de clínica médica de cinco hospitais por meio de técnica observacional, durante 30 dias. Os erros foram classificados em categorias: dose, medicamento não prescrito, via, paciente e horário. A classificação farmacológica dos antimicrobianos foi realizada segundo o Sistema Anatômico Terapêutico Químico (ATC). Os fármacos de intervalo terapêutico estreito foram identificados. A análise estatística descritiva foi realizada no software SPSS 11.5. Foram identificados 1500 erros, sendo 277 (18,5%) com antimicrobianos. Os tipos de erros foram: de horário 87,7%; de dose 6,9%; de medicamento não autorizado 3,2%, de via 1,5% e de paciente 0,7%. Foram identificados 36 antimicrobianos e as classes ATC mais freqüentes foram: fluorquinolonas 13,9%, combinações de penicilinas 13,9%, macrolídeos 8,3% e cefalosporina de terceira geração 5,6%. Os fármacos de intervalo terapêutico estreito corresponderam a 16,7% dos antimicrobianos. Os erros com antimicrobianos analisados podem ser fontes de estudo e melhoria no processo de utilização racional de medicamentos e segurança do paciente.Medication administration errors (MAE) are the most frequent kind of medication errors. Errors with antimicrobial drugs (AD) are relevant because they may interfere in patient safety and in the development of microbial resistance. The aim of this study is to analyze the AD errors detected in a Brazilian multicentric study of MAE. It was a descriptive and exploratory study carried out in clinical units in five Brazilian teaching hospitals. The hospitals were investigated during 30 days. MAE were detected by observation technique. MAE were classified in categories: wrong route(WR), wrong patient(WP), wrong dose(WD) wrong time (WT) and unordered drug (UD). AD with MAE were classified by Anatomical-Therapeutical-Chemical Classification System. AD with narrow therapeutic index (NTI) were identified. A descriptive statistical analysis was performed using SPSS version 11.5 software. A total of 1500 errors were observed, 277 (18.5%) of them were errors with AD. The types of AD error were: WT 87.7%, WD 6.9%, WR 1.5%, UD 3.2% and WP 0.7%. The number of AD found was 36. The mostly ATC class were fluoroquinolones 13.9%, combinations of penicillin 13.9%, macrolides 8.3% and third-generation cephalosporins 5.6%. The parenteral drug dosage form was associated with 55.6% of AD. 16.7% of AD were NTI. 47.4% of WD and 21.8% WT were with NTI drugs. This study shows that these errors should be considered potential areas for improvement in the medication process and patient safety plus there is requirement to develop rational drug use of AD