Potential drug-drug interactions among pneumonia patients: do these matter in clinical perspectives?

Abstract

Background Pneumonia patients are usually hospitalized due to severe nature of the disease or for the management of comorbid illnesses or associated symptoms. Such patients are prescribed with multiple medications which increase the likelihood of potential drug-drug interactions (pDDIs). Therefore, in this study the prevalence, levels (severity and documentation), predictors (risk factors), and clinical relevance of pDDIs among inpatients diagnosed with pneumonia have been investigated. Methods Clinical records of 431 hospitalized patients with pneumonia were checked for pDDIs using drug interactions screening software (Micromedex-DrugReax). Odds-ratios for predictors were calculated using logistic regression analysis. Clinical relevance of pDDIs was assessed by evaluation of patients’ clinical profiles for potential adverse outcomes of the most frequent pDDIs. Abnormal patients’ signs/symptoms and laboratory investigations indicating adverse outcomes of interactions were reported. Results Of total 431 profiles, pDDIs were reported in 73.1%. Almost half of the profiles were having major-pDDIs (53.8%). Total number of pDDIs were 1318, of which 606 were moderate- and 572 were major-pDDIs. Patient’s profiles identified with the most frequent interactions were presented with signs, symptoms, and abnormalities in labs indicating decrease therapeutic response, electrolyte abnormalities, hypoglycemia, bleeding, hepatotoxicity, and hypertension. These adverse events were more prevalent in patients taking higher doses of the interacting drugs as compared to lower doses. Logistic regression analysis revealed significant association for major-pDDIs with 6–10 prescribed medicines (OR = 26.1; p = 0.002), > 10 prescribed medicines (OR = 144; p < 0.001), and tuberculosis (OR = 8.2; p = 0.004). Conclusions PDDIs are highly prevalent in patients with pneumonia. Most frequent and clinically important pDDIs need particular attention. Polypharmacy and tuberculosis increase the risk of pDDIs. Identifying patients more at risk to pDDIs and careful monitoring of pertinent signs/symptoms and laboratory investigations are important measures to reduce pDDIs and their related adverse consequences.

Potential drug–drug interactions associated with adverse clinical outcomes and abnormal laboratory findings in patients with malaria

“…While Additional file 2: Table S2 and Additional file 3: Table S3 enlists most prevalent anti-microbial agents (AMAs) and drugs besides AMAs, respectively. Artesunate (n = 378), quinine (63), artemether (26), lumefantrine (23), primaquine (18), amodiaquine (11), and chloroquine (9) were the commonly prescribed anti-malarial agents to these study patients (Additional file 2: Table S2).…”

Potential drug-drug interactions among elderly in-patients with cardiac illness at a tertiary care centre

“…These findings are consistent with previously conducted studies. 6,14,15 Also, it has been evident from the study, the longer the duration of stay of patient in the hospital the more the risk of developing pDDI. This indirectly correlates to the number of medicines prescribed.…”

“…Study revealed very high prevalence of drug-drug interactions in the cardiac in-patients as supported by other studies. [4][5][6][7] The high prevalence may be due to presence of various risk factors in hospitalized patients. Elderly age group, cardiac illness and associated multiple co-morbidities which in turn lead to polypharmacy, may result into development of drug-drug interactions.…”

“…8 Majority of drug interactions reported in the study were of moderate to major severity as also seen in various other studies. 6,7 (Table 2). Also, the documentation status varied from fair to good evidence.…”

Drug-drug interactions in patients with malaria: a multicenter retrospective study

“…Potential DDIs (pDDIs) issue has been addressed generally in hospitalized patients [7] as well as in specific diseases such as liver cirrhosis [11], hypertension [12], diabetes mellitus (DM) [13], bone marrow transplant [14], cancer [15], stroke [16], pneumonia [17], urinary tract infections [18], and hepatitis C [19]. Despite, being the most prevalent causes of hospitalization [20], DDIs particularly among inpatients with malaria remains unaddressed.…”