Evaluation of potential drug-drug interaction in indoor patients of pediatric department of tertiary care hospital

Abstract

Background: Pediatric population is having high chances of drug-drug interactions (DDIs) because off-label use of drugs, weight-based dose adjustments, and pharmacokinetically, they are different from adult population. Hospitalized pediatric population is more vulnerable to face adverse consequences reserve physiology, medication dosing errors and polypharmacy. Thus, chances are more of potential DDIs (pDDIs) in pediatric patients. There has been focus mainly on adult population, less studies regarding DDIs or pDDIs in pediatric population have been documented. \n \nAims and Objectives: The primary objective of the study is to identify pDDIs in pediatric patients. Determining prevalence, types of pDDIs, and factors associated with pDDIs are secondary objective. \n \nMaterials and Methods: A prospective, observational study was conducted in pediatric ward of tertiary care hospital during April 2018\x96August 2018. The principal investigator collected the data from hospital case papers and recorded in pre-tested case record form. Drugs prescribed in each patient were assessed using Lexicomp software (version 4.4.0), which is internet-based free software used to predict pDDIs. DDIs were categorized in minor, moderate, and major according to their severity assessed by software. If necessary, the investigator also interviewed patients or caretaker to gather information. \n \nResults: A total of 300 patients were included during the study period. Among them, 157 (52.3%) were boys and 143 (48%) were girls. A total number of pDDIs were 235 (78%), of which 227 (97%) were minor and 3 (1.2%) were major DDIs. The most common DDI was between ondansetron and paracetamol (224). A potential major DDIs were observed between ondansetron and dextromethorphan (2) and ondansetron and phenytoin (1). \n \nConclusion: The most common DDIs occurred with ondansetron and paracetamol, which were minor in severity. There were no clinical DDIs. Not all patients with major or moderate DDIs were suffered clinically but better to take due precautions to avoid adverse consequences.