Hospital Pharmacology (Jan 2025)

Polypharmacy and drug interactions in pediatric prescribing

  • Patel Meet P.,
  • Dave Darshan J.,
  • Shukla Apexa B.,
  • Patel Aastha C.,
  • Shah Amit M.

DOI
https://doi.org/10.5937/hpimj2501620p
Journal volume & issue
Vol. 12, no. 1
pp. 1620 – 1627

Abstract

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Introduction: The study addresses the escalating concern of pediatric polypharmacy and potential drug-drug interactions (pDDIs) in the context of pediatric care, where uncertainties regarding medication combinations and safety checks are prevalent. Despite the rising incidence of chronic diseases among children, limited research exists on pediatric polypharmacy, with varying prevalence rates reported globally. Aim: The Aim of the study is to estimate the prevalence of polypharmacy, identify associated factors, and assess potential drug-drug interactions in pediatric prescribing. Material and Methods: This was an academic, prospective, observational and cross-sectional study. Ethical clearance was obtained, and a sample size of 117 pediatric patients was determined based on existing prevalence rates. Data collection involved reviewing treatment records and conducting personal interviews, focusing on socio-demographic profiles, symptoms, and drug therapy. Polypharmacy was defined as the simultaneous use of two or more different medications, and potential drug-drug interactions were assessed using the Drug Interaction Checker by Medscape. Results: Analysis of 117 pediatric patients revealed a high prevalence of polypharmacy (93.16%), with the majority prescribed 3-4 drugs concurrently. Potential drug-drug interactions were observed in 14% of prescriptions, primarily categorized as "Monitor Closely". Albuterol and xylometazoline emerged as the most common drug pair associated with moderate pDDIs. Multivariate logistic regression identified polypharmacy as a significant predictor for pDDIs (p < 0.00017), while age, gender, and weight showed no significant associations. Conclusion: The study underscores the significant prevalence of pediatric polypharmacy and potential drug-drug interactions, highlighting the need for improved prescribing practices and medication safety measures in pediatric care. Addressing these concerns requires ongoing research and development efforts to enhance therapeutic efficacy and safety for pediatric patients.

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