No abstract

Objective: This study seeks to identify potential drug-drug interactions (pDDIs) in hospitalized patients and compare two commercial drug interaction databases. Material and Method: This prospective cross-sectional study was conducted between February and May 2022 in a tertiary care hospital's general pediatric ward. UpToDate® and Micromedex® Drug Interaction databases were used to determine pDDIs. Result and Discussion: In total, 267 pDDIs were found in 51 pediatric patients' medication lists (181 via UpToDate® and 86 via Micromedex®). The use of at least five different systemic drugs concurrently was statistically significant between groups of patients who experienced at least one pDDI and those who did not. The binary logistic regression analysis showed that a one-drug increase in the total number of drugs a patient received during hospitalization increased the probability of pDDIs by 2.12-fold (CI: 1.321-3.417, p=0.002). The concordance rate between UpToDate® and Micromedex® databases for pDDI determination was 84.31% (kappa coefficient=0.676, standard error=0.102, (p ≤ 0.001)). When the UpToDate® database was assumed as a reference database, the Micromedex® database's sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in determining pDDIs were 79.41%, 94.12%, 96.43%, 69.56%, and 84.5%. To avoid missing pDDIs, utilizing multiple drug interaction databases may be of benefit.

The purpose of this study was to investigate the factors that required dose adjustments of antimicrobial drugs in intensive care unit (ICU) patients and to identify the drugs that required the most dose adjustments. The 26-bed reanimation ICU of a university-affiliated hospital hosted this study from September to December 2022. Two clinical pharmacists on duty examined patients' antimicrobial drug dosages daily. The acceptance status of the recommendations and the patients' demographic information were recorded. The study involved 133 ICU patients, and antimicrobial drug recommendations were made for 48 patients, 31 (64.6%) of whom were male. The median (IQR) age of the 48 patients was 67 (54–77). The number of recommendations was 94, and all of them were accepted by the physician. The recommendation rates according to the causes were: inappropriate dosages based on renal functions (71.3%), presence of continuous renal replacement therapy (11.7%), indication (10.6%), body weight (4.3%), and loading dose (2.1%). The top 3 drugs for which recommendations were made the most were colistin (21.3%), meropenem (18.1%), and piperacillin-tazobactam (12.8%). The most troublesome drug was colistin, which is frequently used to treat Acinetobacter pneumonia. Clinical pharmacist and physician collaboration may help rationalize ICU antimicrobial drug use.