Evaluation of potential drug-drug interactions in a pediatric population

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.