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Research Article
Drug-drug interactions associated with adverse clinical outcomes and abnormal laboratory findings in patients with malaria
Mohammad Ismail
University of Peshawar
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7227-3399
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Hospitalized patients with malaria often present with comorbidities or associated complications for which a variety of drugs are prescribed. Multiple drug therapy often leads to drug-drug interactions (DDIs). Therefore, we investigated the prevalence, levels, risk factors, clinical relevance, and monitoring parameters/management guidelines of potential DDIs (pDDIs) among inpatients with malaria. Methods: A retrospective cohort study was carried out at multiple hospital settings. A total of 398 patients’ profiles were evaluated for pDDIs using the Micromedex Drug-Reax ® . Odds ratios were calculated to identify the strength of association between presence of DDIs and potential risk factors via logistic regression analysis. Further, the clinical relevance of frequent pDDIs was investigated. Results: Of 398 patients, pDDIs were observed in 37.2% patients, while major-pDDIs in 19.3% patients. Total 325 interaction were found, of which 45.5% were of major- and 34.5% moderate-severity. Patients with the most common pDDIs were found with signs/symptoms and abnormalities in laboratory findings representing nephrotoxicity, hepatotoxicity, QT interval prolongation, and reduced therapeutic efficacy . The adverse events were more common in patients prescribed with the higher doses of interacting drugs. Multivariate regression analysis showed statistically significant association of pDDIs with 5-6 prescribed medicines (p=0.01), >6 prescribed medicines (p<0.001), >5 days of hospital stay (p=0.03), and diabetes mellitus (p=0.04). Conclusions: PDDIs are commonly observed in patients with malaria. Healthcare professional’s knowledge about the most common pDDIs could help in preventing pDDIs and their associated negative effects. Pertinent clinical parameters, such as laboratory findings and signs/symptoms need to be checked, particularly in patients with polypharmacy, longer hospital stay, and diabetes mellitus.
Keywords
Patient safety, malaria, clinical relevance, potential drug-drug interactions, polypharmacy
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Research Article
Drug-drug interactions associated with adverse clinical outcomes and abnormal laboratory findings in patients with malaria
Mohammad Ismail
University of Peshawar
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7227-3399
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 18 May, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Hospitalized patients with malaria often present with comorbidities or associated complications for which a variety of drugs are prescribed. Multiple drug therapy often leads to drug-drug interactions (DDIs). Therefore, we investigated the prevalence, levels, risk factors, clinical relevance, and monitoring parameters/management guidelines of potential DDIs (pDDIs) among inpatients with malaria. Methods: A retrospective cohort study was carried out at multiple hospital settings. A total of 398 patients’ profiles were evaluated for pDDIs using the Micromedex Drug-Reax ® . Odds ratios were calculated to identify the strength of association between presence of DDIs and potential risk factors via logistic regression analysis. Further, the clinical relevance of frequent pDDIs was investigated. Results: Of 398 patients, pDDIs were observed in 37.2% patients, while major-pDDIs in 19.3% patients. Total 325 interaction were found, of which 45.5% were of major- and 34.5% moderate-severity. Patients with the most common pDDIs were found with signs/symptoms and abnormalities in laboratory findings representing nephrotoxicity, hepatotoxicity, QT interval prolongation, and reduced therapeutic efficacy . The adverse events were more common in patients prescribed with the higher doses of interacting drugs. Multivariate regression analysis showed statistically significant association of pDDIs with 5-6 prescribed medicines (p=0.01), >6 prescribed medicines (p<0.001), >5 days of hospital stay (p=0.03), and diabetes mellitus (p=0.04). Conclusions: PDDIs are commonly observed in patients with malaria. Healthcare professional’s knowledge about the most common pDDIs could help in preventing pDDIs and their associated negative effects. Pertinent clinical parameters, such as laboratory findings and signs/symptoms need to be checked, particularly in patients with polypharmacy, longer hospital stay, and diabetes mellitus.
Figure 1
Figure 2