Abstract
Nirmatrelvir-ritonavir (NMVr) is a recently developed antiviral agent for treating coronavirus disease 2019 (COVID-19); however, data describing its appropriate use are scarce. This study examined the prevalence of inappropriate NMVr use in a Chinese hospital setting. A multicenter retrospective chart review was performed for all hospitalized patients who received NMVr between December 15, 2022, and February 15, 2023, in the four university-affiliated hospitals in Hangzhou, China. A multidisciplinary team of experts developed the evaluation criteria. A group of senior clinical pharmacists examined and verified the suitability of NMVr prescriptions. A total of 247 patients received NMVr during the study period, of which 13.4% (n=31) met all the criteria for the appropriate use of NMVr. The leading types of inappropriate use of NMVr included delayed initiation of treatment (n=147, 59.5%), no dose adjustment for moderate renal impairment (n=46, 18.6%), use in severe-to-critical patients with COVID-19 (n=49, 19.8%), presence of contraindicated drug‒drug interactions with other medications (n=36, 14.6%), and prescriptions for patients without a confirmed diagnosis of COVID-19 (n=36, 14.6%). The proportion of inappropriate use of NMVr was particularly high in the Chinese hospital setting, highlighting the urgent need to improve the appropriate use of NMVr.
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