Sept. 9, 2019
HIV, Infectious Diseases Provider Organizations Call for In-patient Antiretroviral Stewardship
In a policy paper released Friday, the Infectious Diseases Society of America, its HIV Medicine Association and the American Academy of HIV Medicine call for the establishment of antiretroviral treatment stewardship programs in hospital settings to support appropriate use of the drugs, to avoid use of medicines that are incompatible with patients’ regimens, and to avert development of treatment-resistant HIV.
The paper, published in Clinical Infectious Diseases, cites errors in administration of antiretroviral treatment regimens for hospitalized patients with HIV that include incorrect dosing or scheduling of medicines and drug interactions occurring as frequently as 86% of the time in some settings studied. While inpatient errors are often corrected within 48 hours, the paper notes, in some settings they may be corrected in fewer than a quarter of cases before patients’ discharge.
The authors, who include AAHIVM Pharmacist Committee member David Koren and HIVMA Chair Dr. W. David Hardy, write that antiretroviral stewardship programs, modeled on current programs overseeing the use of antibiotics and other antimicrobial medicines in clinical settings and adapted to local needs would help to ensure the continuity of ARV therapy during hospital admission, enhance clinical outcomes and improve overall inpatient care.
The organizations call for advocacy, assessment of best practices, multidisciplinary, institutional-based approaches and resources to expand existing stewardship programs to include expert oversight of antiretroviral treatment.