title: Adverse events caused by potential drug-drug interactions in an intensive care unit of a teaching hospital.
abstract: OBJECTIVE
  To evaluate the incidence of potential drug-drug interactions in an intensive care unit of a hospital, focusing on antimicrobial drugs.
  
  
  METHODS
  This cross-sectional study analyzed electronic prescriptions of patients admitted to the intensive care unit of a teaching hospital between January 1 and March 31, 2014 and assessed potential drug-drug interactions associated with antimicrobial drugs. Antimicrobial drug consumption levels were expressed in daily doses per 100 patient-days. The search and classification of the interactions were based on the Micromedex® system.
  
  
  RESULTS
  The daily prescriptions of 82 patients were analyzed, totaling 656 prescriptions. Antimicrobial drugs represented 25% of all prescription drugs, with meropenem, vancomycin and ceftriaxone being the most prescribed medications. According to the approach of daily dose per 100 patient-days, the most commonly used antimicrobial drugs were cefepime, meropenem, sulfamethoxazole + trimethoprim and ciprofloxacin. The mean number of interactions per patient was 2.6. Among the interactions, 51% were classified as contraindicated or significantly severe. Highly significant interactions (clinical value 1 and 2) were observed with a prevalence of 98%.
  
  
  CONCLUSIONS
  The current study demonstrated that antimicrobial drugs are frequently prescribed in intensive care units and present a very high number of potential drug-drug interactions, with most of them being considered highly significant.
authors.affiliation: Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Mariana Macedo
authors.initials: MM
authors.lastname: Alvim
authors.affiliation: Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Lidiane Ayres da
authors.initials: LA
authors.lastname: Silva
authors.affiliation: Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Isabel Cristina Gonçalves
authors.initials: IC
authors.lastname: Leite
authors.affiliation: Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Marcelo Silva
authors.initials: MS
authors.lastname: Silvério
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D055695:Electronic Prescribing; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents