| Popis: |
In hospital setting, antimicrobials are one of the most commonly prescribed drugs. Due to antimicrobial resistance and treatment cost, rational antimicrobial therapy has become a global health priority. One of the measures to control bacterial resistance is a hospital list of antimicrobials with restricted use. Rational antimicrobial therapy includes therapeutic guidelines but often neglects the risk of potential drug-drug interactions (DDI). Patients undergoing complicated surgical procedures are at an increased risk of DDIs. The aim of this study was to analyse the incidence and type of potential clinically significant DDIs of restricted antimicrobial agents in cardiosurgical patients. This prospective study analysed 146 consecutive restricted antimicrobial requests sent to our Central hospital pharmacy for 95 patients. In total, 232 potential clinically significant DDIs were identified and mean number of clinically significant restricted antimicrobial DDIs was 1.6 per request. Potential interactions were identified by Lexicomp® Lexi- InteractTM Online (Lexi-Comp, Inc., Hudson, USA) software which categorizes potential DDIs according to clinical significance in five types (A, B, C, D and X). Categories C, D and X are of clinical concern and require interventions (specific therapy monitoring, therapy modification or avoiding combination). Most common were DDIs with ciprofloxacin while interactions of highest level of clinical significance were found with moxifloxacin and linezolid. The most common Anatomical Therapeutic Chemical (ATC) drug groups involved in DDIs with antimicrobials were antithrombotics, antiarrythmics, antidiabetics and potassium. Necessary interventions regarding potential DDIs involving antimicrobial drugs need to be coordinated with the pharmacotherapy treatment priorities. |
