Reasons for antibiotics changes:
The reasons for changing antibiotic course are outlined in table 2.
Adverse effects directly caused by intravenous antibiotic use
represented over two-thirds (68%) of the documented reasons mandating a
change in medication The most common reasons were due to drug
intolerance/allergy (19%), clinical deterioration/rising inflammatory
markers (19%), microbiology advice and drug resistances (14%) and
deranged liver function tests (12%). Further detail on microbiology
advice is outlined in figure 3.
When accounting for multiple reasons for one change i.e., deranged liver
function tests and thrombocytopenia, adverse effects from treatment
represents 63% of all reasons for changing antibiotic therapy. There
was a total of 10 inpatient admissions that were directly related to
adverse effects of treatment.
Other non-injurious causes for antibiotic change were drug shortages,
non-compliance, administrative error, and changes for outpatient
antibiotic therapy (OPAT) suitability (18% total).