评估住院病人使用抗生素可能产生的药物间相互作用。

Northern clinics of Istanbul Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI:10.14744/nci.2023.82473
Nurten Nur Aydin, Murat Aydin
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引用次数: 0

摘要

目的:当一种药物改变另一种药物的作用时,就会发生药物间相互作用(DDI)。本研究旨在评估住院患者在使用全身性抗生素时可能发生的药物相互作用(pDDIs):研究对象包括 2022 年 7 月 12 日在我院住院的 18 岁以上患者,他们至少同时使用两种全身性药物,其中至少一种是全身性抗生素。研究采用点流行法进行。使用 UpToDate®/Lexicomp® 数据库系统对患者的药物进行了 pDDIs 评估。根据这一筛查工具,pDDIs 按其严重程度被分为 4 组:结果:在纳入研究的 296 名患者中,有 190 名患者(64.2%)至少发现了一种 pDDI。177 名患者(59.8%)在使用非抗生素药物时至少出现过一次 pDDI。57 名患者(19.3%)至少有一次使用抗生素进行 pDDI。116 名患者(35.8%)没有发生药物相互作用。与抗生素相关的 pDDIs 患者的年龄、合并症数量、用药总数和抗生素数量均明显高于其他患者(P=0.010、P=0.004、P=0.004):在开具抗生素处方之前,应检查是否存在 pDDIs。虽然就 pDDIs 而言,β-内酰胺类抗生素通常被认为是更安全的,但应更加谨慎,尤其是在处方喹诺酮类抗生素时。
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The evaluation of potential drug-drug interactions with antibiotics in hospitalized patients.

Objective: Drug-drug interactions (DDIs) occur when one drug alters the effect of another drug. The aim of this study was to evaluate potential drug-drug interactions (pDDIs) associated with the use of systemic antibiotics in hospitalized patients.

Methods: The study included patients over the age of 18 who were hospitalized in our hospital on 12.07.2022 and were using at least two systemic drugs concurrently, with at least one being a systemic antibiotic. The study was conducted using the point prevalence method. The patients' medication was evaluated for pDDIs using the UpToDate®/Lexicomp® database system. According to this screening tool, pDDIs were classified into 4 groups according to their severity: B, C, D, and X, ranging from mild to severe.

Results: Out of the 296 patients included in the study, at least one pDDI was detected in 190 patients (64.2%). One hundred seventy-seven patients (59.8%) had at least one pDDI with non-antibiotic drugs. Fifty-seven patients (19.3%) had at least one pDDI with antibiotics. One hundred and six patients (35.8%) had no drug interactions. Patients with pDDIs related to antibiotics had significantly higher age, number of comorbidities, total number of medications and number of antibiotics (p=0.010, p=0.004, p<0.001, p<0.001, respectively) compared to patients without pDDIs related to antibiotics (n=239). For antibiotics, potential pDDIs were observed 25, 75, 6, and 6 times in groups B, C, D, and X, respectively. Out of the total of 398 antibiotics, penicillins (24.9%, n=99) and cephalosporins (24.4%, n=97) were the most frequently used. Respectively, eight and two pDDIs were detected with these drugs. While quinolones were used 47 times (11.8%), 74 pDDIs (59.7%) were identified with quinolones. Out of the 47 patients who used quinolones, 37 had pDDIs with antibiotics. The most frequent pDDI with antibiotics was associated with the use of quinolone systemic corticosteroids (15 patients). The second most prevalent interaction involves quinolone-angiotensin converting enzyme inhibitors or angiotensin 2 receptor blockers (13 patients).

Conclusion: Antibiotics should be checked for pDDIs before being prescribed. While beta-lactam antibiotics are generally considered safer in terms of pDDIs, greater caution should be exercised, particularly when prescribing quinolones.

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