PT  - JOURNAL ARTICLE
AU  - Shadi Baniasadi
AU  - Maryam Alehashem
AU  - Amirali Mahboobipour
AU  - Behrooz Farzanegan
TI  - Clinically important drug interactions with anti-infective agents in critically ill patients with respiratory disorders
AID  - 10.1183/13993003.congress-2016.PA3727
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA3727
VI  - 48
IP  - suppl 60
4099  - http://erj.ersjournals.com/content/48/suppl_60/PA3727.short
4100  - http://erj.ersjournals.com/content/48/suppl_60/PA3727.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - 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.