Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
Inera AB, Swedish Association of Local Authorities and Regions, Stockholm, Sweden.
PLoS One. 2019 Aug 5;14(8):e0220685. doi: 10.1371/journal.pone.0220685. eCollection 2019.
To describe the occurrence of potential drug-drug interactions (DDIs) in prescribed drugs, dispensed to pediatric outpatients in Sweden.
A cross sectional study was conducted based on data from a national register of prescribed drugs, dispensed at pharmacies, to children 0-17 years old. The study period was January 1 to April 30, 2010. Drug dispensing data was linked to the DDI database SFINX. Prevalence and frequencies of potential interactions were investigated, and drugs commonly involved in interactions were identified. The study focused on clinically relevant potential interactions, class D (should be avoided), and class C (can be handled, e.g. by dose adjustment).
In the Swedish pediatric population, 0 to 17 years of age, 12% (n = 231 078) of children had at least two dispensed drugs. In this group of patients, 0.14% had potential D-interactions and 1,3% had potential C-interactions. The number of D- and C-interactions that may lead to reduced effects were 181 (52%), and 1224 (32%) respectively. The ten most frequent drugs were involved in 78% and 65% of all potential D-, and C-interactions respectively. Furthermore, 80%, and 58% of the D-, and C-interactions respectively occurred in patients aged 12 to 17.
We identified a limited number of drugs that were represented in the majority of potential interactions. Interactions that can lead to a reduced treatment effect constituted approximately half of D-interactions, and a third of C-interactions. The frequency of potential interactions was higher in older children. The results may contribute to increased prescriber awareness of important potential drug interactions among pediatric outpatients.
描述在瑞典为儿科门诊患者开出的处方药物中潜在药物-药物相互作用（DDI）的发生情况。
这是一项基于全国药房配药登记处的数据开展的横断面研究，研究对象为 0-17 岁的儿童。研究期间为 2010 年 1 月 1 日至 4 月 30 日。药物配药数据与 DDI 数据库 SFINX 进行了链接。调查了潜在相互作用的发生率和频率，并确定了常见的相互作用药物。研究重点是具有临床相关性的潜在相互作用，包括 D 类（应避免）和 C 类（可以处理，例如通过调整剂量）。
在瑞典儿科人群（0-17 岁）中，12%（n=231078）的儿童至少有两种配药。在这组患者中，有 0.14%存在潜在的 D 型相互作用，有 1.3%存在潜在的 C 型相互作用。可能导致疗效降低的 D-和 C-相互作用的数量分别为 181 个（52%）和 1224 个（32%）。十种最常出现的药物分别占所有潜在 D-和 C-相互作用的 78%和 65%。此外，80%和 58%的 D-和 C-相互作用分别发生在 12-17 岁的患者中。
我们确定了少数几种在大多数潜在相互作用中都有代表性的药物。可能导致治疗效果降低的相互作用约占 D 型相互作用的一半，占 C 型相互作用的三分之一。在年龄较大的儿童中，潜在相互作用的频率更高。这些结果可能有助于提高儿科门诊医生对重要潜在药物相互作用的认识。
