Potential Drug-Drug Interactions in Patients With Urinary Tract Infections: A Contributing Factor in Patient and Medication Safety

Abstract

Introduction: Hospitalized patients with urinary tract infections (UTIs) often present with comorbid illnesses and are subsequently prescribed multiple medications, which increases the likelihood of drug-drug interactions. Therefore, this study aimed to explore the prevalence, levels, risk factors, and clinical relevance of potential drug-drug interactions (pDDIs) in hospitalized patients with UTIs. Secondly, we aimed to develop management guidelines and identify monitoring parameters for the most frequent interactions. Methods: A retrospective cross-sectional study was conducted in internal medicine wards of two tertiary care hospitals in Peshawar, Khyber Pakhtunkhwa, Pakistan. The clinical profiles of 422 patients with UTIs were reviewed for pDDIs using the Micromedex Drug-Reax®. Logistic regression was applied to assess the association of pDDIs with various risk factors. The clinical relevance of frequent pDDIs was identified by assessing the potential adverse outcomes of pDDIs including patients’ signs, symptoms, and abnormal laboratory findings. Results: Of 422 patients, at least one pDDI was identified in 62.3% patients, while 40% patients had at least one major pDDI. A total of 1,086 pDDIs were identified, of which 53.4% and 39.3% were of moderate and major severity, respectively. Patients with most frequent pDDIs were presented with hypoglycemia, hepatotoxicity, nephrotoxicity, hypertension, and decreased therapeutic response. These adverse events were more prevalent in patients taking higher doses of interacting drugs. Multivariate regression analysis revealed significant association of pDDIs with six or more medicines (p < 0.001), diabetes mellitus (p < 0.001), ischemic heart disease (p = 0.02), and congestive cardiac failure (p = 0.04). Conclusions: Patients with UTIs present with a considerable number of clinically important pDDIs. Polypharmacy, diabetes mellitus, ischemic heart disease, and congestive cardiac failure increase the risk of pDDIs. Knowledge about the most frequent pDDIs will enable healthcare professionals to implement optimized monitoring and management strategies regarding associated adverse consequences in order to ensure patient safety. Most of the interactions can be managed by considering alternative therapy and dose reduction.

Potential drug interactions in adults living in the Brazilian Amazon: A population-based case-control study, 2019

“…Adults aged between 45 and 59 years experienced higher occurrence of potential drug interaction, similarly to previous reports. 30 , 34 , 35 The elderly usually have higher risk of suffering drug interactions, 36 , 37 , 38 but this association was not significant in this study, possibly due to the low number of older participants. We did not observe associations between drug interactions and gender.…”

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

“…Potential DDIs (pDDIs) issue has been addressed generally in hospitalized patients [ 8 ] as well as in specific diseases such as liver cirrhosis [ 12 ], hypertension [ 13 ], diabetes mellitus (DM) [ 14 ], bone marrow transplant [ 15 ], cancer [ 16 ], stroke [ 17 ], pneumonia [ 18 ], urinary tract infections [ 19 ], and hepatitis C [ 20 ]. Despite, being one of the most prevalent causes of hospitalization in Pakistan during its emerging season [ 21 ].…”

Prospective Study and Analysis of the Pattern of Antimicrobial Utilization for Urinary Tract Infection in Tertiary Care Hospital

“…Apart from the use of these drugs, a large number of other drugs are also prescribed to treat the associated symptoms ijlpr 2022; doi 10.22376/ijpbs/lpr.2022.12.4.P34-40 Pharmacy Practice P-39 and comorbid illnesses. 25 The present study showed that cephalosporins pharmacologic class of antimicrobial drugs were the most-common prescribed antibiotic. This is in agreement with a previous study conducted by other authors 26-28 whereas it is contrary to the result of a study performed by Mohan et al, 29 where amikacin was found to be the most-common prescribed antibiotic in the treatment of UTI.…”