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    Potential Drug-Drug Interactions with Antimicrobials in Hospitalized Patients: A Multicenter Point-Prevalence Study
    (Int Scientific Information, Inc, 2018) Kuscu, Ferit; Ulu, Astihan; Inal, Ayse S.; Suntur, Bedia M.; Aydemir, Hande; Gul, Serdar; Tasova, Yesim
    Background: Improper use of antimicrobials can cause adverse drug events and high costs. The purpose of this study was to investigate the frequency and potential drug-drug interactions associated with antimicrobials among hospitalized patients. Material/Methods: This study was conducted on the same day in 5 different hospitals in Turkey. We included patients aged (3) 18 years who received at least 1 antimicrobial drug and at least 1 of any other drug. The Micromedex (R) online drug reference system was used to control and describe the interactions. Drug interactions were classified as contraindicated, major, moderate, and minor. Results: Potential drug-drug interactions with antimicrobials were 26.4% of all interactions. Five (42%) of 12 contraindicated interactions and 61 (38%) of 159 major interactions were with antimicrobials. Quinolones, triazoles, metronidazole, linezolid, and clarithromycin accounted for 173 (25.7%) of 673 prescribed antimicrobials, but were responsible for 141 (92.1%) of 153 interactions. In multivariate analysis, number of prescribed antimicrobials (odds ratio: 2.3001, 95% CI: 1.6237-3.2582), number of prescribed drugs (odds ratio: 1.2008, 95% CI: 1.0943-1.3177), and hospitalization in the university hospital (odds ratio: 1.7798, 95% CI: 1.0035-3.1564) were independent risk factors for developing drug interactions. Conclusions: Due to risk of drug interactions, physicians should be more cautious when prescribing antimicrobials, particularly when prescribing quinolones, linezolid, azoles, metronidazole, and macrolides.
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    Risk Factors for Colistin-Associated Acute Kidney Injury: A Multicenter Study from Turkey
    (Natl Inst Infectious Diseases, 2016) Gul, Serdar; Kuscu, Ferit; Aydemir, Hande; Ozturk, Dogan Baris; Deveci, Ozcan; Duygu, Fazilet; Aslan, Emel
    The aim of this study was to investigate the incidence of acute kidney injury (AKI) and risk factors due to colistin use in patients infected with multidrug-resistant pathogens. This multicenter, retrospective, observational study was conducted in Turkey, at 5 different research and university hospitals. Cox regression analyses were performed, to determine independent predictors of AKI. From April 2012 to July 2014, a total of 216 patients aged between 18-94 years, treated with colistimethate sodium (CMS) were included in the study. The mean age of the patients was 60.3 +/- 20.1 years. The overall incidence of AKI was 34.3% (74/216) at any time during treatment. Concomitant use of loop diuretics, baseline creatinine level, and CMS dosage were independently associated with AKI. According to our results, patients with higher baseline creatinine levels, or patients who had to use concomitant loop diuretics may need to be monitored more closely, and dose adjustment should be done promptly. More comprehensive studies are, however, still needed to evaluate the efficacy of low-dose colistin since higher doses tend to increase the risk of AKI.