Cargando…

Management of Polypharmacy and Potential Drug–Drug Interactions in Patients with Mycobacterial Infection: A 1-Year Experience of a Multidisciplinary Outpatient Clinic

In 2022, we opened an outpatient clinic for the management of polypharmacy and potential drug–drug interactions (pDDIs) in patients with mycobacterial infection (called GAP-MyTB). All patients who underwent a GAP-MyTB visit from March 2022 to March 2023 were included in this retrospective analysis....

Descripción completa

Detalles Bibliográficos
Autores principales: Cattaneo, Dario, Torre, Alessandro, Schiuma, Marco, Civati, Aurora, Lazzarin, Samuel, Rizzardini, Giuliano, Gori, Andrea, Antinori, Spinello, Gervasoni, Cristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10375959/
https://www.ncbi.nlm.nih.gov/pubmed/37508267
http://dx.doi.org/10.3390/antibiotics12071171
_version_ 1785079152901095424
author Cattaneo, Dario
Torre, Alessandro
Schiuma, Marco
Civati, Aurora
Lazzarin, Samuel
Rizzardini, Giuliano
Gori, Andrea
Antinori, Spinello
Gervasoni, Cristina
author_facet Cattaneo, Dario
Torre, Alessandro
Schiuma, Marco
Civati, Aurora
Lazzarin, Samuel
Rizzardini, Giuliano
Gori, Andrea
Antinori, Spinello
Gervasoni, Cristina
author_sort Cattaneo, Dario
collection PubMed
description In 2022, we opened an outpatient clinic for the management of polypharmacy and potential drug–drug interactions (pDDIs) in patients with mycobacterial infection (called GAP-MyTB). All patients who underwent a GAP-MyTB visit from March 2022 to March 2023 were included in this retrospective analysis. Fifty-two patients were included in the GAP-MyTB database. They were given 10.4 ± 3.7 drugs (2.8 ± 1.0 and 7.8 ± 3.9 were, respectively, antimycobacterial agents and co-medications). Overall, 262 pDDIs were identified and classified as red-flag (2%), orange-flag (72%), or yellow-flag (26%) types. The most frequent actions suggested after the GAP-MyTB assessment were to perform ECG (52%), therapeutic drug monitoring (TDM, 40%), and electrolyte monitoring (33%) among the diagnostic interventions and to reduce/stop proton pump inhibitors (37%), reduce/change statins (14%), and reduce anticholinergic burden (8%) among the pharmacologic interventions. The TDM of rifampicin revealed suboptimal exposure in 39% of patients that resulted in a TDM-guided dose increment (from 645 ± 101 to 793 ± 189 mg/day, p < 0.001). The high prevalence of polypharmacy and risk of pDDIs in patients with mycobacterial infection highlights the need for ongoing education on prescribing principles and the optimal management of individual patients. A multidisciplinary approach involving physicians and clinical pharmacologists could help achieve this goal.
format Online
Article
Text
id pubmed-10375959
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-103759592023-07-29 Management of Polypharmacy and Potential Drug–Drug Interactions in Patients with Mycobacterial Infection: A 1-Year Experience of a Multidisciplinary Outpatient Clinic Cattaneo, Dario Torre, Alessandro Schiuma, Marco Civati, Aurora Lazzarin, Samuel Rizzardini, Giuliano Gori, Andrea Antinori, Spinello Gervasoni, Cristina Antibiotics (Basel) Article In 2022, we opened an outpatient clinic for the management of polypharmacy and potential drug–drug interactions (pDDIs) in patients with mycobacterial infection (called GAP-MyTB). All patients who underwent a GAP-MyTB visit from March 2022 to March 2023 were included in this retrospective analysis. Fifty-two patients were included in the GAP-MyTB database. They were given 10.4 ± 3.7 drugs (2.8 ± 1.0 and 7.8 ± 3.9 were, respectively, antimycobacterial agents and co-medications). Overall, 262 pDDIs were identified and classified as red-flag (2%), orange-flag (72%), or yellow-flag (26%) types. The most frequent actions suggested after the GAP-MyTB assessment were to perform ECG (52%), therapeutic drug monitoring (TDM, 40%), and electrolyte monitoring (33%) among the diagnostic interventions and to reduce/stop proton pump inhibitors (37%), reduce/change statins (14%), and reduce anticholinergic burden (8%) among the pharmacologic interventions. The TDM of rifampicin revealed suboptimal exposure in 39% of patients that resulted in a TDM-guided dose increment (from 645 ± 101 to 793 ± 189 mg/day, p < 0.001). The high prevalence of polypharmacy and risk of pDDIs in patients with mycobacterial infection highlights the need for ongoing education on prescribing principles and the optimal management of individual patients. A multidisciplinary approach involving physicians and clinical pharmacologists could help achieve this goal. MDPI 2023-07-10 /pmc/articles/PMC10375959/ /pubmed/37508267 http://dx.doi.org/10.3390/antibiotics12071171 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cattaneo, Dario
Torre, Alessandro
Schiuma, Marco
Civati, Aurora
Lazzarin, Samuel
Rizzardini, Giuliano
Gori, Andrea
Antinori, Spinello
Gervasoni, Cristina
Management of Polypharmacy and Potential Drug–Drug Interactions in Patients with Mycobacterial Infection: A 1-Year Experience of a Multidisciplinary Outpatient Clinic
title Management of Polypharmacy and Potential Drug–Drug Interactions in Patients with Mycobacterial Infection: A 1-Year Experience of a Multidisciplinary Outpatient Clinic
title_full Management of Polypharmacy and Potential Drug–Drug Interactions in Patients with Mycobacterial Infection: A 1-Year Experience of a Multidisciplinary Outpatient Clinic
title_fullStr Management of Polypharmacy and Potential Drug–Drug Interactions in Patients with Mycobacterial Infection: A 1-Year Experience of a Multidisciplinary Outpatient Clinic
title_full_unstemmed Management of Polypharmacy and Potential Drug–Drug Interactions in Patients with Mycobacterial Infection: A 1-Year Experience of a Multidisciplinary Outpatient Clinic
title_short Management of Polypharmacy and Potential Drug–Drug Interactions in Patients with Mycobacterial Infection: A 1-Year Experience of a Multidisciplinary Outpatient Clinic
title_sort management of polypharmacy and potential drug–drug interactions in patients with mycobacterial infection: a 1-year experience of a multidisciplinary outpatient clinic
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10375959/
https://www.ncbi.nlm.nih.gov/pubmed/37508267
http://dx.doi.org/10.3390/antibiotics12071171
work_keys_str_mv AT cattaneodario managementofpolypharmacyandpotentialdrugdruginteractionsinpatientswithmycobacterialinfectiona1yearexperienceofamultidisciplinaryoutpatientclinic
AT torrealessandro managementofpolypharmacyandpotentialdrugdruginteractionsinpatientswithmycobacterialinfectiona1yearexperienceofamultidisciplinaryoutpatientclinic
AT schiumamarco managementofpolypharmacyandpotentialdrugdruginteractionsinpatientswithmycobacterialinfectiona1yearexperienceofamultidisciplinaryoutpatientclinic
AT civatiaurora managementofpolypharmacyandpotentialdrugdruginteractionsinpatientswithmycobacterialinfectiona1yearexperienceofamultidisciplinaryoutpatientclinic
AT lazzarinsamuel managementofpolypharmacyandpotentialdrugdruginteractionsinpatientswithmycobacterialinfectiona1yearexperienceofamultidisciplinaryoutpatientclinic
AT rizzardinigiuliano managementofpolypharmacyandpotentialdrugdruginteractionsinpatientswithmycobacterialinfectiona1yearexperienceofamultidisciplinaryoutpatientclinic
AT goriandrea managementofpolypharmacyandpotentialdrugdruginteractionsinpatientswithmycobacterialinfectiona1yearexperienceofamultidisciplinaryoutpatientclinic
AT antinorispinello managementofpolypharmacyandpotentialdrugdruginteractionsinpatientswithmycobacterialinfectiona1yearexperienceofamultidisciplinaryoutpatientclinic
AT gervasonicristina managementofpolypharmacyandpotentialdrugdruginteractionsinpatientswithmycobacterialinfectiona1yearexperienceofamultidisciplinaryoutpatientclinic