Drug-Drug Interactions Among Pediatric Intensive Care Unit: Risk Factors and Clinical Outcomes

Drug–drug interactions (DDIs) are a common concern in pediatric intensive care units (PICUs) and may increase the risk of medication-related adverse events. This study aimed to determine the frequency, categories, and associated factors of potential DDIs in a PICU. We conducted a cross-sectional study between June ۲۰۲۲ and February ۲۰۲۳ among children admitted for at least ۴۸ hours to medical or surgical PICUs who received two or more prescribed medications. Potential DDIs were identified and classified using Lexi-Interact®️. Demographic and clinical data, as well as medication-related information, were collected prospectively, and severity and reliability ratings were recorded. Associations with potential DDIs were analyzed using univariable and multivariable logistic regression. Among ۳۴۵ included patients, ۱,۸۵۸ potential DDIs were detected, including ۱,۲۴۸ (۶۷%) category C interactions, ۵۲۹ (۲۹%) category D interactions, and ۸۱ (۴%) category X interactions. Potential DDIs were more frequent in the medical PICU than in the surgical PICU. The most frequent contraindicated (category X) interaction involved linezolid–methadone. In multivariable analysis, the number of prescribed drugs, use of sedative agents, and PICU type were significantly associated with the occurrence of potential DDIs. In conclusion, potential DDIs were common in this PICU cohort. Polypharmacy, particularly involving sedative agents, was an important modifiable factor associated with potential DDIs. Enhanced monitoring and medication review may help identify and manage high-risk potential DDIs in critically ill pediatric patients.

کلیدواژه ها:

Pediatrics ، Critical care ، Intensive care unit ، Drug Interactions ، Medication errors