Clinically relevant drug interactions involving antimicrobials in a general hospital: a cross-sectional study

Abstract

Objective: To assess the prevalence of pDDI involving antimicrobials and other standardized drugs in a large general hospital in the interior of São Paulo. Methods: quantitative study, with cross-sectional design and data collection by documentary analysis of hospital prescriptions from April to June 2017. Results: 66 clinically relevant pDDI were found, which corresponded to approximately 7.3% of antimicrobial prescriptions, being 93.9% (62) contraindicated / severe and 6.1% (4) moderate. There was no difference in the prevalence of clinically relevant pDDIs between critical and non-critical inpatient, in addition to all contraindicated interactions (10) having occurred in the clinical and surgical units. The most prevalent pDDI were, with respective degrees of documentation, between vancomycin and amikacin (47% - reasonable), clarithromycin and simvastatin (13.6% - good), and ciprofloxacin and simvastatin (7.6% - good). Conclusion: For the proper prevention of potential drug-related problems, mechanisms to guarantee the quality of prescriptions by trained clinical pharmacists are of fundamental importance, in addition to alert systems and drug interaction information for the health team, then ensuring quality pharmacotherapy and patient safety.

Assessment of potential drug-drug interactions in hospitalized patients with infectious diseases: an experience from a secondary care hospital

“…19,20,24 Furthermore, earlier studies by Baniasadi et al, and Pavanello et al, in critical care patients showed that the most common drug class involved in pDDIs was anti-infective for systemic use, accounting for 51.5% and 45.8%, respectively. 22,25 The difference in study settings, varying profiles of study populations, disagreement in treatment guidelines and prescribing practice, and the use of different clinical decision support tools to analyze drug interactions may help explain the difference in the class of drugs involved in the onset of pDDIs.…”

Potenciais interações medicamentosas relacionadas ao uso de antimicrobianos em pacientes hospitalizados em hemodiálise

“…Como a maioria desses medicamentos possui eliminação renal e alguns são nefrotóxicos, os mesmos podem estar associados a RAMs graves nesses pacientes 12 . Um estudo que avaliou a prevalência de potenciais IMs envolvendo antimicrobianos e outros medicamentos padronizados em um hospital, identificou que 19,7% dos antimicrobianos da unidade estavam envolvidos em potenciais IMs clinicamente relevantes 13 .…”

“…13,2%) e penicilinas 23 (10,5%), e no sétimo dia carbapenêmicos 27 (17,3%) e lipopeptídeos 17(10,9%). Já as classes de antimicrobianos mais prevalentes nas IMs ao longo dos 7 dias foram: antifúngicos 162 (28,6%), seguido das fluoroquinolonas 97 (17,1%) e oxazolidinona 76 (13,4%) (tabela 4).…”