title: Drug-drug interactions in the intensive care unit: Do they really matter?
abstract: To describe prevalence and patterns of potential drug-drug interactions (pDDIs) in the intensive care unit (ICU), occurrence of adverse drug events (ADEs), and agreement between different compendia and intensivists' perceptions.
  
  
  
  A cross-sectional study. Drug profiles of all adult patients from 2 academic ICUs were screened on day 3 upon admission. We identified pDDIs using 3 compendia (Stockley's, Micromedex, and Epocrates) and documented their mechanism of action, clinical consequences, severity, level of evidence, and management. Medical records were searched to identify ADEs potentially related to major pDDIs. Agreement between information sources (compendia, intensivists) was evaluated.
  
  
  
  We identified 1120 pDDIs among 275 patients. Median number of pDDIs per patient was 3.0 (interquartile range, 1-6), with 79% of patients presenting with at least 1 pDDI. Major pDDIs were detected in 18% of patients, with potentially related to ADEs in 4% of patients. Only 13% of all pDDIs were documented simultaneously in all 3 compendia. Different information sources (compendia, clinicians) showed "no" to "fair" agreement.
  
  
  
  Potential drug-drug interactions occurred in most ICU patients, contrasting with low rates of potentially related ADEs, which may have been underestimated. Sources of information are inconsistent, challenging the identification of pDDIs.
authors.affiliation: Université catholique de Louvain, Cliniques universitaires Saint Luc, Bruxelles-Department of Pharmacy, Brussels, Belgium. Electronic address: delphine@vanham.eu.
authors.forename: D
authors.initials: D
authors.lastname: Vanham
authors.affiliation: Université catholique de Louvain, Louvain Drug Research Institute, Clinical Pharmacy Research Group, Brussels, Belgium; Université catholique de Louvain, CHU Dinant-Godinne UCL Namur-Department of Pharmacy, Yvoir, Belgium. Electronic address: anne.spinewine@uclouvain.be.
authors.forename: A
authors.initials: A
authors.lastname: Spinewine
authors.affiliation: Université catholique de Louvain, Cliniques universitaires Saint Luc, Bruxelles-Department of Intensive Care, Brussels, Belgium; Université catholique de Louvain, Cliniques universitaires Saint Luc, Bruxelles-Louvain Centre for Toxicology and Applied Pharmacology, Brussels, Belgium. Electronic address: philippe.hantson@uclouvain.be.
authors.forename: Ph
authors.initials: P
authors.lastname: Hantson
authors.affiliation: Université catholique de Louvain, Cliniques universitaires Saint Luc, Bruxelles-Department of Intensive Care, Brussels, Belgium. Electronic address: xavier.wittebole@uclouvain.be.
authors.forename: X
authors.initials: X
authors.lastname: Wittebole
authors.affiliation: Université catholique de Louvain, Cliniques universitaires Saint Luc, Bruxelles-Department of Pharmacy, Brussels, Belgium. Electronic address: dominique.wouters@uclouvain.be.
authors.forename: D
authors.initials: D
authors.lastname: Wouters
authors.affiliation: Université catholique de Louvain, Cliniques universitaires Saint Luc, Bruxelles-Department of Pharmacy, Brussels, Belgium. Electronic address: Barbara.sneyers@chu-charleroi.be.
authors.forename: B
authors.initials: B
authors.lastname: Sneyers
mesh_terms: D000328:Adult; D000368:Aged; D001530:Belgium / Q000453:epidemiology; D003422:Critical Care; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D015995:Prevalence
keywords: Adverse drug events; Drug-drug interactions; Intensive care unit; Interrater reliability; Prevalence