Hassanzad Maryam, Tashayoie Nejad Sabereh, Mahboobipour Amir Ali, Salem Farzaneh, Baniasadi Shadi
Pediatric Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Drug Metab Pers Ther. 2020 Jan 31;35(1):/j/dmdi.2020.35.issue-1/dmpt-2019-0012/dmpt-2019-0012.xml. doi: 10.1515/dmpt-2019-0012.
Background Hospitalized pediatric patients are at an increased risk of experiencing potential drug-drug interactions (pDDIs) due to polypharmacy and the unlicensed and off-label administration of drugs. The aim of this study is to characterize clinically significant pDDIs in pediatric patients hospitalized in a tertiary respiratory center. Methods A retrospective analysis of medications prescribed to pediatric patients admitted to the pediatric ward (PW) and pediatric intensive care unit (PICU) of a respiratory referral center was carried out over a six-month period. The pDDIs were identified using the Lexi-Interact database and considered as clinically relevant according to the severity rating as defined in the database. Frequency, drug classes, mechanisms, clinical managements, and risk factors were recorded for these potential interactions. Results Eight hundred and forty-five pDDIs were identified from the analysis of 176 prescriptions. Of the total pDDIs, 10.2% in PW and 14.6% in PICU were classified as clinically significant. Anti-infective agents and central nervous system drugs were the main drug classes involved in clinically significant pDDIs as object and/or precipitant drugs. A higher number of medications [odds ratio (OR): 4.8; 95% confidence interval (CI): 2.0-11.4; p < 0.001] and the existence of a nonrespiratory disease, which led to a respiratory disorder (OR: 3.8; 95% CI: 1.40-10.4; p < 0.05), were the main risk factors associated with an increased incidence of pDDIs. Conclusions A high and similar risk of pDDIs exists in pediatric patients with respiratory disorders hospitalized in PW and PICU. The patients prescribed a higher number of medications and presenting respiratory symptoms induced by a nonrespiratory disease require extra care and monitoring. Pediatricians should be educated about clinically significant DDIs for highly prescribed medications in their settings in order to take preventive measures and safeguard patient safety.
背景 由于多药合用以及药物的未获许可和超说明书用药，住院儿科患者发生潜在药物相互作用（pDDIs）的风险增加。本研究的目的是描述在一家三级呼吸中心住院的儿科患者中具有临床意义的pDDIs。方法 对一家呼吸转诊中心儿科病房（PW）和儿科重症监护病房（PICU）收治的儿科患者在6个月期间所开具药物进行回顾性分析。使用Lexi-Interact数据库识别pDDIs，并根据数据库中定义的严重程度评级将其视为具有临床相关性。记录这些潜在相互作用的频率、药物类别、机制、临床处理和危险因素。结果 从176份处方分析中识别出845例pDDIs。在所有pDDIs中，PW中有10.2%、PICU中有14.6%被归类为具有临床意义。抗感染药物和中枢神经系统药物是作为目标和/或引发药物参与具有临床意义的pDDIs的主要药物类别。药物数量较多[比值比（OR）：4.8；95%置信区间（CI）：2.0 - 11.4；p < 0.001]以及存在导致呼吸障碍的非呼吸系统疾病（OR：3.8；95%CI：1.40 - 10.4；p < 0.05）是与pDDIs发生率增加相关的主要危险因素。结论 在PW和PICU住院的患有呼吸系统疾病的儿科患者中，pDDIs的风险较高且相似。开具药物数量较多且出现由非呼吸系统疾病引起的呼吸道症状的患者需要格外关注和监测。应教育儿科医生了解其所在环境中高处方率药物的具有临床意义的药物相互作用，以便采取预防措施并保障患者安全。
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