Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar 9;55(1):30-38.
doi: 10.14744/TurkPediatriArs.2019.60938. eCollection 2020.

Evaluation of potential drug-drug interactions in a pediatric population

Berna Terzioğlu Bebitoğlu  1 , Elif Oğuz  1 , Çağatay Nuhoğlu  2 , Ayşe Ela Kurtdan Dalkılıç  2 , Pelin Çirtlik  2 , Fatime Temel  1 , Ajla Hodzic  1
Affiliations

Evaluation of potential drug-drug interactions in a pediatric population

Berna Terzioğlu Bebitoğlu et al. Turk Pediatri Ars. .

Abstract
in English, Turkish

Aim: A large number of medications are prescribed in pediatric clinics and this leads to the development of drug-drug interactions (DDI) that may complicate the course of the disease. The aim of the study was to identify the prevalence of potential drug-drug interactions, to categorize main drug classes involved in severe drug-drug interactions and to highlight clinically relevant DDIs in a pediatric population.

Material and methods: A total of 1500 prescriptions during the 12-month study period were retrospectively reviewed; 510 prescriptions that comprised two or more drugs were included in study. The presence of potential drug-drug interactions was identified by using the Lexi-Interact database and categorized according to severity A (unknown), B (minor), C (moderate), D (major), and X (contraindicated).

Results: There were 1498 drugs in 510 prescriptions; 253 of these (49.6%) included 2 drugs, 228 (44.7%) included 3-4 drugs, and 29 (5.6%) included ≥5 drugs. A total of 634 (42%) potential drug-drug interactions were idenfied. Among those, 271 (42.7%) were categorized as A, 284 (44.8%) as B, 53 (8.4%) as C, and 26 (4.1%) as D. There was no potential risk for X interaction. Anti-infectives (36%) were the most commonly prescribed drug classes involved in C and/or D categories. Clarithromycin was the most commonly interacting agent that interfered with budesonide.

Conclusion: It is noteworthy that a significant number of drugs causing potential drug-drug interactions are prescribed together in pediatric clinics. Increasing the awareness of physicians on this issue will prevent potential complications and ensure patient safety.

Amaç: Çocuk kliniklerinde çok sayıda ilaç reçete edilmektedir ve bu durum hastalığın seyrini kötüleştirebilecek ilaç-ilaç etkileşimlerinin oluşmasına neden olabilmektedir. Bu çalışmanın amacı, potansiyel ilaç-ilaç etkileşimlerinin yaygınlığını ve ciddi etkileşime giren başlıca ilaç gruplarını belirlemek ve çocuk yaş grubunda klinik olarak önemli ilaç-ilaç etkileşimlerini vurgulamaktır.

Gereç ve yöntemler: 12 aylık çalışma döneminde toplam 1 500 reçete geriye dönük olarak incelendi; bunlar içerisinden iki ya da daha fazla ilaç içeren 510 reçete çalışmaya alındı. Potansiyel ilaç-ilaç etkileşimlerinin varlığı, Lexi-Interact veritabanı kullanılarak belirlendi ve ciddiyetine göre sınıflandı: A (bilinmeyen), B (minor), C (orta), D (major) ve X (kontrendike).

Bulgular: 510 reçetede toplam 1498 ilaç vardı; bunların 253’ü (%49,6) 2 ilaç, 228’i (%44,7) 3–4 ilaç ve 29’u (%5,6) ≥5 ilaç içermekte idi. Toplam 634 (%42) potansiyel ilaç-ilaç etkileşimi belirlendi. Bunlardan 271’i (%42,7) A, 284’ü (%44,8) B, 53’ü (%8,4) C ve 26’sı (%4,1) D grubu etkileşim olarak sınıflandırıldı. X etkileşimi içeren risk saptanmadı. C ya/ya da D kategorisinde en yaygın reçete edilen ilaç grubu anti-infektifler (%36) idi. Klaritromisin, budesonide ile etkileşen ve en sık etkileşime giren ilaç idi.

Çikarimlar: Çocuk kliniklerinde potansiyel ilaç-ilaç etkileşimlerine neden olan ilaçların sıklıkla birlikte reçete edilmesi dikkat çekicidir. Klinisyenlerin bu konudaki farkındalığının arttırılması olası komplikasyonları önleyecek ve hasta güvenliğini artıracaktır.

Keywords: Drug-drug interactions; pediatric; pharmacology; prescriptions.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The distribution of interaction categories according to the number of drugs in prescriptions is presented
See this image and copyright information in PMC

References

    1. Salem F, Rostami-Hodjegan A, Johnson TN. Do children have the same vulnerability to metabolic drug–drug interactions as adults?A critical analysis of the literature. J Clin Pharmacol. 2013;53:559–66. - PubMed
    1. Martinbiancho J, Zuckermann J, Dos Santos L, Silva MM. Profile of drug interactions in hospitalized children. Pharm Pract (Granada) 2007;5:157–61. - PMC - PubMed
    1. Papadopoulos J, Smithburger PL. Common drug interactions leading to adverse drug events in the intensive care unit:management and pharmacokinetic considerations. Crit Care Med. 2010;38:S126–35. - PubMed
    1. Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients:a meta-analysis of prospective studies. JAMA. 1998;279:1200–5. - PubMed
    1. Salerno SN, Burckart GJ, Huang SM, Gonzalez D. Pediatric Drug-Drug Interaction Studies:Barriers and Opportunities. Clin Pharmacol Ther. 2019;105:1067–70. - PMC - PubMed

LinkOut - more resources