A Cross-Sectional Investigation on Drug-Drug Interactions in Prescriptions of Pediatric Outpatient Clinics at a Referral Center in Southern Iran

Abstract

Background: Drug interactions can lead to treatment failure, the occurrence of side effects, complicate the clinical course and severity of the disease, and prolong hospitalization duration. Pediatrics are particularly vulnerable to drug interactions. Objectives: This study aims to evaluate prescribed medications and the incidence of drug interactions in pediatric patients. Methods: This study was conducted as a cross-sectional investigation. Over nine months, we evaluated pediatric patients referred to Bandar Abbas Children’s Hospital, affiliated with Hormozgan University of Medical Sciences, who received outpatient treatment services. The medications these patients received were assessed for drug interactions. Only interactions with clinical importance (i.e., category C-D-X) were considered. Using the Lexi-Interact online database, the prescribed drugs were evaluated in terms of the number and type of potential drug-drug interactions. Results: A total of 1011 patients were included in the study based on the determined criteria. The mean age was 4.52 ± 0.11 years, and the male-to-female ratio was 1.2:1. More than two-thirds of the patients were seen by general physicians. Among all participants, 26.7% had at least one clinically significant interaction in their prescriptions. Furthermore, 309 interactions were identified, of which 6.39% were of significant severity, and 93.61% were of moderate severity. The risk rating of C was the most common interaction, followed by X and D (87.7%, 7.4%, and 4.8%, respectively). Regarding reliability, 0.30% had fair reliability, 64.20% had good reliability, and 35.50% had excellent reliability ratings. Patients with underlying conditions were at increased risk of interaction occurrence (OR = 1.8, P = 0.008). Conclusions: Drug interactions with high clinical significance were identified at a high prevalence rate. These interactions can have significant consequences. Pharmacists and physicians play an important role in identifying and managing drug-drug interactions.