ABSTRACT
Background and ImportanceTreatment guidelines for COVID-19 have rapidly been evolving. Different drugs against COVID-19 have urgently emerged to control the pandemic, challenging hospital pharmacies to make these antiviral and immunomodulatory therapies timely available for admitted patients.Aim and ObjectivesTo analyse the prescribing patterns of COVID-19 drugs in our hospital and its impact on the pharmacy's workload.Material and MethodsWe retrospectively analysed drug registration data from 1 January 2020 to 16 March 2022 of COVID-19 drugs (dexamethasone, remdesivir, baricitinib, casirivimab/imdevimab and sotrovimab) for hospitalised patients. Consumption data were expressed as number of patients and number of preparations. To determine pharmacy's workload, we measured the average time for drug ordering, preparation and dispensing. Hydroxychloroquine and baricitinib were excluded as these are commercially available oral drugs which are distributed according to standard procedures.ResultsThe volume of dispensed COVID-19 drugs fluctuated along with the hospitalisation waves of the COVID-19 epidemic. Oral dexamethasone was the most frequently prescribed drug throughout the whole period, which is consistent with the strong recommendation in the national guideline. Remdesivir, introduced in our practice since October 2020, was the second most prescribed drug despite low evidence. From October 2021 until December 2021, 41 infusions of remdesivir were administered, compared to 381 infusions from January 2022 until March 2022. Compared to dexamethasone and remdesivir, monoclonal antibodies (casirivimab/imdevimab and sotrovimab) were less commonly used: 48 prepared infusions between September 2021 and March 2022. Most drugs were given in combination. Remdesivir and monoclonal antibodies were manually ordered to fulfil urgent needs as the supply is managed nationwide by the government. Infusions were prepared at once due to limited stability. Ordering, preparing and dispensing required an average of 35 minutes per patient to complete.Conclusion and RelevanceThe COVID-19 pandemic impacted pharmacy's workload. We could have made more timesaving decisions such as the use of commercially available methylprednisolone instead of dexamethasone and batching remdesivir preparations. Hospital pharmacists should be involved in developing national guidelines and take into account the impact on daily practice.References and/or Acknowledgements1. Sciensano, Interim clinical guidance for adults with confirmed COVID-19, July 2022, Version 29Conflict of InterestNo conflict of interest