{
  "abstract": "Background While simnotrelvir-ritonavir and nirmatrelvir-ritonavir, the oral antiviral agents targeting the 3C-like proteases, are widely used in China, robust data on their appropriate use remain limited in hospitalised patients. We therefore examined the appropriateness of simnotrelvir-ritonavir versus nirmatrelvir-ritonavir in the inpatient setting.Methods A retrospective study was conducted to compare the potentially inappropriate use of simnotrelvir-ritonavir and nirmatrelvir-ritonavir in hospitalised patients between 1 July 2023 and 31 December 2023 in Beijing, China. Four factors are taken into consideration when defining and critiquing potentially inappropriate use: indications, dosage and timing of administration, contraindications and drug–drug interactions.Results We have identified 278 simnotrelvir-ritonavir and nirmatrelvir-ritonavir prescriptions in 226 hospitalised COVID-19 patients, of which 49.6% (138 prescriptions) satisfied all the criteria for appropriate use. Nirmatrelvir-ritonavir prescriptions were more likely to have potentially inappropriate indications (12.4% vs 3.2%, p=0.006) or dosage and timing of administration (13.1% vs 4.0%, p=0.009) than simnotrelvir-ritonavir prescriptions. Nirmatrelvir-ritonavir was prescribed to two patients in the presence of contraindications (severe renal impairment). No significant differences were identified in drug–drug interactions (DDIs) (p=0.657) and contraindicated DDIs (p=0.670) between simnotrelvir-ritonavir and nirmatrelvir-ritonavir. The most common contraindicated co-medication was estazolam, followed by quetiapine and clopidogrel.Conclusions About half of the patients use simnotrelvir-ritonavir and nirmatrelvir-ritonavir that might potentially be inappropriate. More extensive research is required to supplement the empirical evidence supporting COVID-19 therapeutics. Additionally, appropriate therapy requires collaboration with pharmacists and education on the appropriate use of COVID-19 therapeutics among physicians and patients.",
  "authors": [
    {
      "affiliations": [
        "Department of Pharmacy, Beijing Chao-Yang Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Yuezhen Zhu"
    },
    {
      "affiliations": [
        "Department of Pharmacy, Beijing Chao-Yang Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Yi Zhang"
    },
    {
      "affiliations": [
        "Department of Pharmacy, Beijing Chao-Yang Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Hui Yang"
    },
    {
      "affiliations": [
        "Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Chunguo Jiang"
    },
    {
      "affiliations": [
        "Department of Pharmacy, Beijing Chao-Yang Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Wanying Chen"
    },
    {
      "affiliations": [
        "Department of Pharmacy, Beijing Chao-Yang Hospital Capital Medical University, Beijing, China",
        "Department of Pharmacy, Capital Medical University Beijing Obstetrics and Gynecology Hospital, Beijing, China"
      ],
      "name": "Hui Zhang"
    },
    {
      "affiliations": [
        "Department of Pharmacy, Beijing Chao-Yang Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Xintong Zhang"
    },
    {
      "affiliations": [
        "Department of Pharmacy, Beijing Chao-Yang Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Han Wu"
    },
    {
      "affiliations": [
        "Department of Pharmacy, Beijing Chao-Yang Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Jia Li"
    },
    {
      "affiliations": [
        "Department of Pharmacy, Beijing Chao-Yang Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Zhuoling An"
    }
  ],
  "title": "Prevalence of potentially inappropriate use of antiviral therapy with simnotrelvir-ritonavir versus nirmatrelvir-ritonavir in hospitalised patients: a retrospective study in Beijing, China",
  "uid": "241bb2a7-deb2-5293-b221-da45e73c115e"
}