title: Potential drug-drug interactions in pediatric outpatient prescriptions for newborns and infants.
abstract: OBJECTIVE
  To surveyed the quantities, types, and related information of potential drug-drug interactions (DDIs) and estimate the off-label use percentage of pediatric outpatient prescriptions for newborns and infants from the National Health Insurance Research Database (NHIRD) of Taiwan.
  
  
  BACKGROUND
  Adverse drug reactions (ADR) may cause morbidity and mortality, potential drug-drug interactions (DDI) increase the probability of ADR. Research on ADR and DDI in infants is of particular urgency and importance but the related profiles in these individuals are not well known.
  
  
  METHODS
  All prescriptions written by physicians in 2000 were analyzed to identify potential DDIs among drugs appearing on the same prescription sheet.
  
  
  RESULTS
  Of a total of 150.6 million prescription sheets, with 669.5 million prescriptions registered in the NHIRD of Taiwan, six million (3.99%) prescription sheets were for 2.1 million infants with 19.4 million (2.85%) prescriptions. There were 672,020 potential DDIs in this category, accounting for 3.53% per prescription; an estimated one DDI in every three patients. The interactions between aspirin and aluminum/magnesium hydroxide were most common (4.42%). Of the most significant drug-drug interactions, the interaction of digoxin with furosemide ranked first (20.14%), followed by the interactions of cisapride with furosemide and erythromycin (6.02% and 4.85%, respectively). The interactions of acetaminophen and anti-cholinergic agents comprised most types of drug-drug interactions (6.62%).
  
  
  CONCLUSIONS
  Although the prevalence rates of DDIs are low, life-threatening interactions may develop. Physicians must be reminded of the potential DDIs when prescribing medications for newborns and infants.
authors.affiliation: Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Oriental Institute of Technology, New Taipei, Taiwan. Electronic address: fk002@mail.oit.edu.tw.
authors.forename: Min-Li
authors.initials: ML
authors.lastname: Yeh
authors.forename: Ying-Jui
authors.initials: YJ
authors.lastname: Chang
authors.forename: Shu-Jen
authors.initials: SJ
authors.lastname: Yeh
authors.forename: Li-Jung
authors.initials: LJ
authors.lastname: Huang
authors.forename: Yung-Tai
authors.initials: YT
authors.lastname: Yen
authors.forename: Po-Yen
authors.initials: PY
authors.lastname: Wang
authors.forename: Yu-Chuan
authors.initials: YC
authors.lastname: Li
authors.forename: Chien-Yeh
authors.initials: CY
authors.lastname: Hsu
mesh_terms: D004347:Drug Interactions; D011307:Drug Prescriptions; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D056687:Off-Label Use; D010045:Outpatients; D011336:Probability; D013624:Taiwan
keywords: Adverse drug reactions; Drug–drug interactions; Information technology; National Health Insurance; Patient safety