Department of Infectious Diseases and Clinical Microbiology, Cukurova University Faculty of Medicine, Adana, Turkey.
Department of Infectious Diseases and Clinical Microbiology, Adana Numune Training and Research Hospital, Adana, Turkey.
Med Sci Monit. 2018 Jun 20;24:4240-4247. doi: 10.12659/MSM.908589.
BACKGROUND Improper use of antimicrobials can cause adverse drug events and high costs. The purpose of this study was to investigate the frequency and potential drug-drug interactions associated with antimicrobials among hospitalized patients. MATERIAL AND METHODS This study was conducted on the same day in 5 different hospitals in Turkey. We included patients aged ³18 years who received at least 1 antimicrobial drug and at least 1 of any other drug. The Micromedex® online drug reference system was used to control and describe the interactions. Drug interactions were classified as contraindicated, major, moderate, and minor. RESULTS Potential drug-drug interactions with antimicrobials were 26.4% of all interactions. Five (42%) of 12 contraindicated interactions and 61 (38%) of 159 major interactions were with antimicrobials. Quinolones, triazoles, metronidazole, linezolid, and clarithromycin accounted for 173 (25.7%) of 673 prescribed antimicrobials, but were responsible for 141 (92.1%) of 153 interactions. In multivariate analysis, number of prescribed antimicrobials (odds ratio: 2.3001, 95% CI: 1.6237-3.2582), number of prescribed drugs (odds ratio: 1.2008, 95% CI: 1.0943-1.3177), and hospitalization in the university hospital (odds ratio: 1.7798, 95% CI: 1.0035-3.1564) were independent risk factors for developing drug interactions. CONCLUSIONS Due to risk of drug interactions, physicians should be more cautious when prescribing antimicrobials, particularly when prescribing quinolones, linezolid, azoles, metronidazole, and macrolides.
抗菌药物使用不当可导致药物不良事件和医疗费用增加。本研究旨在调查住院患者中抗菌药物的使用频率及潜在的药物-药物相互作用。
本研究于土耳其 5 家不同医院的同一天进行。我们纳入了至少使用 1 种抗菌药物和至少 1 种其他药物的年龄³18 岁的患者。采用 Micromedex®在线药物参考系统来控制和描述相互作用。药物相互作用分为禁忌、主要、中度和轻度。
抗菌药物相关的潜在药物-药物相互作用占所有相互作用的 26.4%。12 种禁忌相互作用中有 5 种(42%)与抗菌药物有关,159 种主要相互作用中有 61 种(38%)与抗菌药物有关。喹诺酮类、三唑类、甲硝唑、利奈唑胺和克拉霉素占 673 种规定抗菌药物的 173 种(25.7%),但与 153 种相互作用有关的有 141 种(92.1%)。多变量分析表明,规定使用的抗菌药物数量(比值比:2.3001,95%可信区间:1.6237-3.2582)、规定使用的药物数量(比值比:1.2008,95%可信区间:1.0943-1.3177)和在大学医院住院(比值比:1.7798,95%可信区间:1.0035-3.1564)是发生药物相互作用的独立危险因素。
由于存在药物相互作用的风险,医生在开处方时应更加谨慎,特别是在开喹诺酮类、利奈唑胺、唑类、甲硝唑和大环内酯类药物时。