Clinically Relevant Interactions with Anti-Infectives on Intensive Care Units—A Multicenter Delphi Study
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Clinically Relevant Interactions with Anti-Infectives on Intensive Care Units—A Multicenter Delphi Study. / Koeck, Joachim Andreas; Hilgarth, Heike; Ameln-Mayerhofer, Andreas von; Meyn, Damaris; Warlich, Ruediger; Münstedt, Andreas; Horn, Dagmar; Koenig, Christina.
In: ANTIBIOTICS-BASEL, Vol. 10, No. 11, 1330, 31.10.2021.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Clinically Relevant Interactions with Anti-Infectives on Intensive Care Units—A Multicenter Delphi Study
AU - Koeck, Joachim Andreas
AU - Hilgarth, Heike
AU - Ameln-Mayerhofer, Andreas von
AU - Meyn, Damaris
AU - Warlich, Ruediger
AU - Münstedt, Andreas
AU - Horn, Dagmar
AU - Koenig, Christina
PY - 2021/10/31
Y1 - 2021/10/31
N2 - Patients in intensive care units (ICUs) are at high risk of drug-drug interactions (DDIs) due to polypharmacy. Little is known about type and frequency of DDIs within German ICUs. Clinical pharmacists' interventions (PI) recorded in a national database (ADKA-DokuPIK) were filtered for ICU patients. Binary DDIs involving ≥1 anti-infective agent with >1 database entry were selected. A modified two-step Delphi process with a group of senior hospital pharmacists was employed to evaluate selected DDIs for clinical relevance by using a five-point scale and to develop guidance for clinical practice. In total, 16,173 PI were recorded, including 1836 (11%) DDIs in the ICU setting. Of the latter, 41% (756/1836) included ≥1 anti-infective agent, 32% (590/1836) were binary DDIs, and 25% (455/1836) were listed at least twice. This translates into 88 different DDIs, 74% (65/88) of which were rated as being clinically relevant by our expert panel. The majority of DDIs (76% [67/88]) included macrolides, antifungals, or fluoroquinolones. This percentage was even higher in DDIs being rated as clinically relevant by the experts (85% [55/65]). It is noted that an inter-professional discussion and approach is needed in the individual patient management of DDIs. The guidance developed might be a tool for decision support.
AB - Patients in intensive care units (ICUs) are at high risk of drug-drug interactions (DDIs) due to polypharmacy. Little is known about type and frequency of DDIs within German ICUs. Clinical pharmacists' interventions (PI) recorded in a national database (ADKA-DokuPIK) were filtered for ICU patients. Binary DDIs involving ≥1 anti-infective agent with >1 database entry were selected. A modified two-step Delphi process with a group of senior hospital pharmacists was employed to evaluate selected DDIs for clinical relevance by using a five-point scale and to develop guidance for clinical practice. In total, 16,173 PI were recorded, including 1836 (11%) DDIs in the ICU setting. Of the latter, 41% (756/1836) included ≥1 anti-infective agent, 32% (590/1836) were binary DDIs, and 25% (455/1836) were listed at least twice. This translates into 88 different DDIs, 74% (65/88) of which were rated as being clinically relevant by our expert panel. The majority of DDIs (76% [67/88]) included macrolides, antifungals, or fluoroquinolones. This percentage was even higher in DDIs being rated as clinically relevant by the experts (85% [55/65]). It is noted that an inter-professional discussion and approach is needed in the individual patient management of DDIs. The guidance developed might be a tool for decision support.
UR - https://www.mdpi.com/2079-6382/10/11/1330
U2 - 10.3390/antibiotics10111330
DO - 10.3390/antibiotics10111330
M3 - SCORING: Journal article
VL - 10
JO - ANTIBIOTICS-BASEL
JF - ANTIBIOTICS-BASEL
SN - 2079-6382
IS - 11
M1 - 1330
ER -
