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Clinically important drug interactions with anti-infective agents in critically ill patients with respiratory disorders

Shadi Baniasadi, Maryam Alehashem, Amirali Mahboobipour, Behrooz Farzanegan
European Respiratory Journal 2016 48: PA3727; DOI: 10.1183/13993003.congress-2016.PA3727
Shadi Baniasadi
1Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
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Maryam Alehashem
1Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
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Amirali Mahboobipour
2School of Medicine, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
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Behrooz Farzanegan
1Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
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Abstract

Introduction: Drug-drug interactions (DDIs) are an important concern for patients admitted to intensive care units (ICUs). Since anti-infective agents are commonly prescribed for critically ill patients with respiratory disorders, the DDIs related to these agents should be considered by the physicians.

Aims: We aimed to identify anti-infective drug interactions with clinically important consequences in ICU-admitted patients in order to improve treatment outcomes and patient safety.

Methods: A prospective study was carried out in a respiratory referral hospital. The medication records of ICU-admitted patients receiving antibiotics were reviewed twice a week. The presence, mechanism, severity, reliability, outcome, and management of potential DDIs were determined by a clinical pharmacologist.

Results: During the 6 months, 184 patients were included in the study. From 398 prescribed anti-infective agents, 124 lead to major and contraindicated interactions. The inhibition/induction of drug metabolizer enzymes (61.32%), synergistic effect (21.69%), and altered absorption (13.2%) were the most frequent mechanisms of potential interactions. The inhibition of tacrolimus and cyclosporine metabolism by azole antifungal agents (9.43%) and QTc prolongation by co-administration of quinolones and macrolides with other torsadogenic drugs (17.92%) were the most frequent clinically significant DDIs.

Conclusions: Critically ill patients with respiratory disorders are predisposed to clinically significant anti-infective drug interactions. Monitoring therapeutic and adverse effects, dose adjustment, and considering an alternative drug are recommended for clinical management.

  • Critically ill patients
  • Interaction
  • Pharmacology
  • Copyright ©the authors 2016
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Clinically important drug interactions with anti-infective agents in critically ill patients with respiratory disorders
Shadi Baniasadi, Maryam Alehashem, Amirali Mahboobipour, Behrooz Farzanegan
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3727; DOI: 10.1183/13993003.congress-2016.PA3727

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Clinically important drug interactions with anti-infective agents in critically ill patients with respiratory disorders
Shadi Baniasadi, Maryam Alehashem, Amirali Mahboobipour, Behrooz Farzanegan
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3727; DOI: 10.1183/13993003.congress-2016.PA3727
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