Evaluation of Interactions of Antibiotics with Other Drugs in Intensive Care Patients

Öz

Objective:The aim of this study was to determine the interactions of antibiotics with other drugs in intensive care patients with 3 different online drug-drug interaction databases frequently used in hospitals, to compare these databases and to evaluate the clinical significance of drug interactions by the clinical pharmacist.

Method:The patients who are hospitalized at a university Hospital Internal Medicine Intensive Care Unit during November and December 2015 and use at least one antibiotic were included in the study. Interactions among drugs that are used by patients were evaluated by using databases of Micromedex, Medscape and Drugs.com online drug-drug interactions sections and antibiotic-drug interactions were identified. The differences in the numbers and severity of potential drug interactions among the databases were recorded. The clinical significance of identified drug interaction was evaluated by a clinical pharmacist.

Results:A total of 42, 112 and 91 drug-drug interactions were identified in 62 patients by the Micromedex, Medscape and Drugs.com respectively. When the clinical significance of these interactions were evaluated, 15 (35.7%) of the drug interactions detected with the Medscape database were clinically significant.

Conclusion:An evaluation of drug interaction should not solely be based on the databases, but should include the interpretation of a clinical pharmacist or clinician on its clinical significance.

Anahtar Kelimeler

• antibiotic,drug interaction,online database

Yoğun Bakım Hastalarında Antibiyotiklerin Diğer İlaçlarla Etkileşimlerinin Değerlendirilmesi

Öz

Amaç:Bu çalışmanın amacı, yoğun bakım hastalarında antibiyotiklerin diğer ilaçlarla olan etkileşimlerini, hastanelerde sıklıkla başvurulan 3 farklı online ilaç-ilaç etkileşim veri tabanı ile saptamak, bu veri tabanlarını karşılaştırmak ve ilaç etkileşimlerinin klinik önemini klinik eczacı tarafından değerlendirmektir. 

Yöntem:Kasım-Aralık 2015 tarihleri arasında bir üniversite hastanesi Dahiliye Yoğun Bakım Ünitesi’nde yatmakta olan ve en az bir antibiyotik kullanan hastalar çalışmaya dahil edilmiştir. Hastaların kullandığı ilaçlar arasındaki etkileşimler; Micromedex, Medscape ve Drugs.com online veri tabanlarının ilaç-ilaç etkileşim bölümleri ile analiz edilmiş ve antibiyotiklerle olan potansiyel ilaç-ilaç etkileşimleri belirlenmiştir. Veri tabanlarında gözlenen potansiyel ilaç-ilaç etkileşimlerinin sayısı ve derecesi arasındaki farklar tespit edilmiştir. Saptanan etkileşimlerin klinik açıdan önemi bir klinik eczacı tarafından değerlendirilmiştir.

Bulgular:Altmış iki hastada toplam 42, 112 ve 91 ilaç etkileşimi Micromedex, Medscape ve Drugs.com tarafından sırasıyla belirlenmiştir. Saptanan bu etkileşimlerin klinik önemi değerlendirildiğinde, en fazla Medscape veri tabanı ile saptanan ilaç etkileşimleri 15’i (%35,7) klinik olarak anlamlı bulunmuştur.

Sonuç: Etkileşimlerin değerlendirilmesinde sadece veri tabanları ile saptanmayıp aynı zamanda klinik eczacı ve klinisyenlerin klinik anlamlılığı göz önünde bulundurduğu bir yaklaşım izlenmelidir.

Anahtar Kelimeler

• antibiyotik,ilaç etkileşimi,veri tabanı

Kaynakça

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