Pharmacy asked to consider ending long-term antibiotic aid after death – NZ Herald

This is despite the risk being highlighted in at least two updates published by MedSafe in the last decade.

A recommendation will now be made for Pharmaceuena to consider suspending drug subsidies for more than six months to “special control” authorizations only, as a way to prevent its availability.

After his death in 2019, the man’s wife complained to the HDC, mainly to help prevent “another avoidable death due to the lack of professional knowledge about the adverse effects of the drug”.

He was initially prescribed medication by a specialist in the spine department of the district health board.

It had successfully treated his symptoms, so his GP and a urologist at another community hospital continued to prescribe it, without making sure the man understood the risks of long-term use. The pharmacy also dispensed the medication without advising the man of the risks, Cooper found.

He had been taking the drug for about 28 months between 2017 and 2019 and was never informed of the known risk of lung disease from its long-term use.

About six to eight months after starting the medication the man developed a mild and dry cough, but neither he nor his wife knew that this could be related and nitrofurantoin, did not raise any concerns about this at the time.

The opinion of the research experts was that when the use of nitrofurantoin exceeds six months, he should be told about the possible risks in order to make an informed decision about whether the benefits of continuing with it outweigh the risks.

Cooper said it was “significant” that none of the health care providers treating the man, identified in the ruling as Mr A, had confirmed he understood the risks, so he assumed no one person or service is primarily responsible.

“Clearly several providers failed Mr A.”

Cooper said the complaint highlighted that some doctors who prescribed and administered nitrofurantoin, including those who treated the man, were unaware of the potential for serious lung damage from long-term use. more than six months.

“It shed light on a very important issue and encouraged the necessary reforms and education to reduce the chances of a similar situation in the future,” he said.

The providers involved have made significant changes and improvements.

The pharmacy that issued the medicine asked the Pharmacy Safety Association to provide the correct information to all public entrepreneurs. The owner said that before the incident they were not aware of any danger.

“When we first discussed this as a group, I found out that some of our pharmacists are aware of an unusual side effect associated with long-term use of nitrofurantoin… Some pharmacists they did not know this … .”

The spine center at Health NZ is creating an information document that will be shared with the College of General Practitioners and the medical center has conducted a review of all patients prescribed this medication to monitor and ensure that side effects are replicated. .

The man’s GP has since made “dramatic changes” to prescribing practices including providing written information from the New Zealand Formulary for all long-term medicines for patients and consulting with see about the side effects involved.

In addition to the changes already made, Cooper listed the following recommendations including that the RCollege of General Practitioners and Te Tāhū Hauora|Health Quality and Safety Commission consider the best way to highlight awareness of the risks of medicines. .

With a recommendation to Medsafe and the Medical Safety Association, Cooper believed that a more direct approach to the urology community was better with the publication of standard information about the risks of long-term use of nitrofurantoin.

Cooper said when he concluded the investigation he believed and supported the wishes of the man’s wife when she made the complaint.

Tracy Neal is the Nelson-based Open Justice reporter for NZME. He was previously RNZ’s regional reporter in Nelson-Marlborough and covered general news, including council and local government for the Nelson Mail.