Analysis of COVID-19 Patients Prescriptions Using Hydroxychloroquine in an Intensive Care Unit

Abstract

Introduction: Even in health emergencies, when experimental therapies are used, it is important to regard the medication safety and efficacy, and the analysis of medical prescriptions is one of the ways to monitor safety aspects. Objective: quantify and classify Potential Drug Interactions (PDIs) with Hydroxychloroquine (HCQ) according to risk in prescriptions for patients with COVID-19 in use of HCQ admitted to an Intensive Care Unit (ICU) of a Teaching Hospital. Methodology: This cross-sectional study was based on the analysis of 162 prescriptions from 38 patients with COVID-19 using HCQ in an ICU. Micromedex® and UpToDate® were the databases to support clinical management used to establish PDI. Results: The mean number of days of hospitalization was 16.1 ± 14.0 and the mean number of days using HCQ was 4.26 ± 1.74. 87.14% of prescriptions presented PDI and the most common was between HCQ and azithromycin. 77.77% of prescriptions had at least one PDI between drugs that prolong the QT interval. Conclusions: Considering the risks of exposing critical patients to drug interactions, this study demonstrates the need to strengthen the culture of monitoring drug safety and efficacy parameters in health institutions, even in experimental therapies with utilization off-label drugs indication, to minimize risks and expand possible benefits.

Keywords: COVID-19. Hydroxychloroquine. Intensive Care Unit.