Background
Methods
Study design and setting
Administrative and ethical approval
Data source
Screening of prescriptions for pDDIs
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Contraindicated: The drugs are contraindicated for concurrent use.
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Major: The interaction may be life threatening and/or require medical intervention to minimize or prevent adverse effects.
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Moderate: The interaction may result in exacerbation of the patient condition and/or require an alteration in therapy.
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Minor: The interaction would have limited clinical effects. Manifestations may include an increase in the frequency or severity of the side effects, but generally would not require a major alteration in therapy.
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Excellent: Controlled studies have clearly established the existence of the interaction.
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Good: Documentation strongly suggests the interaction exists, but well-controlled studies are lacking.
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Fair: Available documentation is poor, but pharmacological considerations lead clinicians to suspect the interaction exists; or documentation is good for a pharmacologically similar drug.
Statistical analysis
Results
Characteristics | Patients: n (%) |
---|---|
Gender | |
Male | 1088 (45.3) |
Age (years) | |
≤ 10 | 766 (31.9) |
11–20 | 386 (16.1) |
21–30 | 443 (18.5) |
31–40 | 310 (12.9) |
41–50 | 292 (12.2) |
51–60 | 138 (5.8) |
> 60 | 65 (2.7) |
Prescribed medicines per patient | |
≤ 3 | 962 (40.1) |
4–6 | 1235 (51.5) |
> 6 | 203 (8.5) |
Drugs | |
Median (IQR) | 4 (3–5) |
Clinical specialties | |
Medicine | 687 (28.6) |
Pediatrics | 610 (25.4) |
Dermatology | 235 (9.8) |
Ear Nose and Throat | 190 (7.9) |
Surgical | 132 (5.5) |
Chest | 124 (5.2) |
Psychiatry | 114 (4.8) |
Cardiology | 89 (3.7) |
Gynecology | 78 (3.3) |
Orthopedic | 73 (3) |
Dentistry | 39 (1.6) |
Miscellaneous | 29 (1.2) |
Characteristics | All types of interactions (n = 534) | Only major interactions (n = 225) |
---|---|---|
n (%a) | n (%a) | |
Gender | ||
Male | 230 (21.1) | 101 (9.3) |
Female | 304 (23.2) | 124 (9.5) |
Age (Years) | ||
≤ 10 | 41 (5.4) | 64 (8.4) |
11–20 | 79 (20.5) | 32 (8.3) |
21–30 | 129 (29.1) | 44 (9.9) |
31–40 | 87 (28.1) | 28 (9) |
41–50 | 100 (34.2) | 37 (12.7) |
51–60 | 59 (42.8) | 12 (8.7) |
> 60 | 39 (60) | 8 (12.3) |
Prescribed medicines | ||
≤ 3 | 141 (14.7) | 95 (9.9) |
4–6 | 315 (25.5) | 115 (9.3) |
> 6 | 78 (38.4) | 15 (7.4) |
Clinical Specialties | ||
Medicine | 221 (32.2) | 58 (8.4) |
Pediatrics | 31 (5.1) | 56 (9.2) |
Dermatology | 15 (6.4) | 19 (8.1) |
Ear Nose and Throat | 36 (18.9) | 17 (8.9) |
Surgical | 31 (23.5) | 12 (9.1) |
Chest | 37 (29.8) | 13 (10.5) |
Psychiatry | 58 (50.9) | 11 (9.6) |
Cardiology | 62 (69.7) | 12 (13.5) |
Gynecology | 19 (24.4) | 13 (16.7) |
Orthopedic | 12 (16.4) | 10 (13.7) |
Dentistry | 4 (10.3) | 3 (7.7) |
Miscellaneous | 8 (27.6) | 1 (3.4) |
Interacting Pair | Severity levels | Documentation levels | Patients: n (%a) | Potential adverse outcomes |
---|---|---|---|---|
Ibuprofen – Levofloxacin | Moderate | Fair | 50 (2) | Seizures |
Ciprofloxacin – Diclofenac | Moderate | Excellent | 32 (1.3) | Increased ciprofloxacin plasma concentrations |
Aspirinb – Atenolol | Moderate | Good | 24 (1) | Decreased antihypertensive effect |
Diclofenac – Levofloxacin | Moderate | Fair | 19 (0.8) | Seizures |
Diclofenac – Metronidazole | Moderate | Fair | 17 (0.7) | Increased exposure of diclofenac |
Aspirinc – Clopidogrel | Moderate | Fair | 16 (0.7) | Bleeding |
Ciprofloxacin – Metronidazole | Major | Fair | 14 (0.6) | QT-interval prolongation |
Amlodipine – Diclofenac | Moderate | Good | 14 (0.6) | Gastrointestinal hemorrhage and/or antagonism of hypotensive effect |
Levofloxacin – Prednisolone | Moderate | Excellent | 13 (0.5) | Tendon rupture |
Atorvastatin – Clopidogrel | Moderate | Excellent | 13 (0.5) | Increased platelet reactivity |
Aspirinb – Glimepiride | Moderate | Good | 13 (0.5) | Hypoglycemia |
Glimepiride – Levofloxacin | Major | Fair | 12 (0.5) | Hypoglycemia or hyperglycemia |
Aspirinc – Bisoprolol | Moderate | Good | 12 (0.5) | Decreased antihypertensive effect |
Levofloxacin – Thioridazine | Contraindicated | Fair | 12 (0.5) | QT interval prolongation |
Aminophylline – Levofloxacin | Major | Fair | 12 (0.5) | Theophylline toxicity (nausea, vomiting, palpitations, seizures) |