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Journal of critical care · Apr 2017
Multicenter StudyDrug-drug interactions in the intensive care unit: Do they really matter?
- D Vanham, A Spinewine, Ph Hantson, X Wittebole, D Wouters, and B Sneyers.
- Université catholique de Louvain, Cliniques universitaires Saint Luc, Bruxelles-Department of Pharmacy, Brussels, Belgium. Electronic address: delphine@vanham.eu.
- J Crit Care. 2017 Apr 1; 38: 97-103.
PurposeTo describe prevalence and patterns of potential drug-drug interactions (pDDIs) in the intensive care unit (ICU), occurrence of adverse drug events (ADEs), and agreement between different compendia and intensivists' perceptions.MethodsA cross-sectional study. Drug profiles of all adult patients from 2 academic ICUs were screened on day 3 upon admission. We identified pDDIs using 3 compendia (Stockley's, Micromedex, and Epocrates) and documented their mechanism of action, clinical consequences, severity, level of evidence, and management. Medical records were searched to identify ADEs potentially related to major pDDIs. Agreement between information sources (compendia, intensivists) was evaluated.ResultsWe identified 1120 pDDIs among 275 patients. Median number of pDDIs per patient was 3.0 (interquartile range, 1-6), with 79% of patients presenting with at least 1 pDDI. Major pDDIs were detected in 18% of patients, with potentially related to ADEs in 4% of patients. Only 13% of all pDDIs were documented simultaneously in all 3 compendia. Different information sources (compendia, clinicians) showed "no" to "fair" agreement.ConclusionsPotential drug-drug interactions occurred in most ICU patients, contrasting with low rates of potentially related ADEs, which may have been underestimated. Sources of information are inconsistent, challenging the identification of pDDIs.Copyright © 2016 Elsevier Inc. All rights reserved.
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