Experience with drotrecogin in two Australian hospitals

Mackenzie, F. D., Pillans, P. I., Cook, D. A., Dixon, A. E. and Kubler, P. A. (2006) Experience with drotrecogin in two Australian hospitals. Journal of Pharmacy Practice and Research, 36 3: 185-186.

Author Mackenzie, F. D.
Pillans, P. I.
Cook, D. A.
Dixon, A. E.
Kubler, P. A.
Title Experience with drotrecogin in two Australian hospitals
Journal name Journal of Pharmacy Practice and Research   Check publisher's open access policy
ISSN 1445-937X
Publication date 2006-01-01
Sub-type Critical review of research, literature review, critical commentary
Open Access Status Not yet assessed
Volume 36
Issue 3
Start page 185
End page 186
Total pages 2
Place of publication Collingwood, VIC, Australia
Publisher Society of Hospital Pharmacists of Australia
Language eng
Subject 110310 Intensive Care
111502 Clinical Pharmacology and Therapeutics
Formatted abstract
Background: Drotrecogin alfa (activated) is a recombinant human activated protein C approved to reduce mortality in patients with severe sepsis. In the PROWESS study, a 28 day mortality rate of 24.7% was observed in septic patients treated with drotrecogin compared to 30.8% in the placebo group.

Aim: To compare experience in inpatients with sepsis with the published experience and assess compliance with Queensland Hospitals Drug Advisory Committee prescribing protocol. Method: A retrospective review was conducted using data obtained from patients treated with drotrecogin over a 2 year period at two Brisbane hospitals. Data collection included patient demographics, presenting condition, past medical history, medications, compliance with the prescribing protocol, clinical outcome and safety.

Results: 22 patients were treated with drotrecogin. The mean age was 48.7 years (range 17- 81). All patients complied with the protocol inclusion criteria, had evidence of serious infection, required mechanical ventilation and had 2 or more organ failures. 6 patients (27%) died during the 28 day post- administration period. A number of patients had significant comorbidities including 4 with cirrhosis and 3 with cancer. Patients often received the drug despite having conditions listed as precautions and relative contraindications. There were 2 confirmed cases of serious bleeding complications.

Conclusions: Treatment outcomes were comparable to the original trial results, despite the selection of more critically ill patients. All patients met strict inclusion criteria, but consideration of relative contraindications and comorbidities could be improved.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
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Created: Wed, 01 Apr 2009, 02:25:48 EST by Sophie Jordan on behalf of School of Medicine