[Availability of antidotes in hospital pharmacies in the Czech Republic].

Availability of antidotes in the Czech Republic (CR) is insufficient. Many antidotes are not approved in CR, so their obtaining is problematic. The purpose of this study is to examine the real availability of antidotes in Czech hospital pharmacies and to assess the influence of hospital size, hospital localisation, antidote cost, and the fact of antidote approval in CR on antidote availability. Finally, some proposals for the solution of the situation are mentioned. A structured questionnaire was constructed and mailed to 85 hospital pharmacies. A total of 46 hospital pharmacies sent back completely answered questionnaires and they were statistically assessed. The questionnaire included a summary of poisonings and usable antidotes. The recommended quantity of each antidote was included. Availability of antidotes (D) and sufficient availability of antidotes (DD) were calculated for each answering hospital pharmacy as a ratio of poisonings for which the antidote was available or available in a sufficient quantity, to all poisonings mentioned in the questionnaire. The other calculated parameter was the availability of an individual antidote (d) and the sufficient availability of an individual antidote (dd)--they were calculated as a ratio of pharmacies stocking the antidote, or stocking the antidote in a sufficient quantity, to evaluated pharmacies. Availability of 23 different antidotes for 20 poisonings was assessed. Antidotes for roughly one half of assessed poisonings are available (D 55.69 +/- 12.42%) and for about one third of poisonings the antidotes are available in a sufficient quantity (DD--37.23 +/- 14.10%). The D and DD have been dependent on hospital size (measured as the number of beds). D and DD have not been dependent on the localisation of the hospital (measured as a period of transport time to the hospital of higher type of care), d and dd ranged between 0-100% and were dependent on the antidote cost. There were significant differences between d and dd of antidotes approved (R) and unapproved (NR) in CR (d(R)--70.51 +/- 33.26%, d(NR)--10.19 +/- 9.26%, p < 0.001; dd(R)--47.55 +/- 29.94%, dd(NR)--6.93 +/- 7.76%, p < 0.001). The results of the study confirm a very unsatisfactory situation in antidote availability in Czech hospital pharmacies. Hospital stocks of many antidotes are inadequate. Often, the antidotes are available, but their quantity is insufficient. The worst situation is in small hospitals, in the very costly antidotes, and in the antidotes not registered in CR.