Pattern of systemic antibiotic use and potential drug interactions: evaluations through a point prevalence study in Ankara University Hospitals

Abstract

Background/aim Most of the hospitalized patients are on a number of drugs for comorbidities and/or to prevent nosocomial infections. This necessitates a careful consideration of drug interactions not only to avoid possible toxicities but also to reach the highest efficiency with drug treatment. We aimed to investigate drug interactions related to systemic antibiotic use and compare three different databases to check for drug interactions while characterizing the main differences between medical and surgical departments. Materials and methods This point prevalence study covered data on 927 orders for patients hospitalized between June 3 and 10, 2018 in Ankara University Hospitals. Systemic antibiotic use and related drug interactions were documented using UptoDate, Drugs, and Medscape and comparisons between the departments of medical and surgical sciences were made. Results The number of orders, or the number of drugs or antibiotics per order were not different between the medical and surgical sciences departments. A total of 1335 antibiotic-related drug interactions of all levels were reported by one, two, or all three databases. UptoDate reported all common and major interactions. Pantoprazole was the most commonly prescribed drug and appeared in 63% of all orders. Among 75 different molecules, ceftriaxone and meropenem were the two most prescribed antibiotics by the surgical and medical departments, respectively. Conclusion A dramatic variance existed amongst antibiotics prescribed by different departments. This indicated the requirement for a centralized role of an infectious diseases specialist. Especially for the hospitalized patient, prophylactic coverage with at least one antibiotic brought about a number of drug interactions. A precise evaluation of orders in terms of drug interactions by a clinical pharmacist (currently none on duty) will reduce possible drug-related hazards.

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

“…Infected individuals often require hospital admission, leading to a higher risk of morbidity, mortality, and increased healthcare expenditures. 1 Indeed, appropriate selection and rational use of antimicrobial agents are often challenging for healthcare providers. 2,3 Drug-drug interactions (DDIs) occur when two or more co-administered drugs interact, with one drug altering the effect of the co-administered drug.…”

Clinically important pharmacokinetic drug-drug interactions with antibacterial agents

“…Pharmacokinetic (PK) interactions occur when the precipitant drug changes the object drug’s absorption, distribution, metabolism, or excretion. These interactions are typically managed by monitoring drug concentrations or vital signs [ 5 , 6 ].…”