基于药学信息数据库的治疗支原体肺炎的抗感染药物相互作用

Drug-drug interactions of antimicrobial agents in patients with mycoplasmal pneumonia based on pharmaceutical information database

目的评价治疗支原体肺炎(MP)的抗感染药物的相互作用(DDI)并提出管理建议,为临床合理用药提供参考。方法基于3个药物信息数据库(Micromedex、Lexicomp和DDInter数据库)检索MP诊疗指南所涉及的全部抗感染药物DDI,进行逐一查询并分析。结果治疗MP的11种抗感染药物在3个数据库中均存在多种DDI。大环内酯类药物DDI较多,需重点关注合并有糖尿病、高血脂等患者的共用药物;四环素类药物需关注与抗癫痫药物DDI,以及与含有金属阳离子的制剂合用时进行必要的用药交代;喹诺酮类药物应关注与抗凝药物、抗酸药物等之间的DDI,必要时调整给药方案并进行指标监测。结论对于多病共存,多药同服患者,DDI可能频繁发生,临床医师和药师必要时应调整用药方案并进行恰当地监护,避免因DDI引起药物不良反应或治疗失败,促进临床合理用药。

AIM To evaluate the drug-drug interactions(DDIs)of antimicrobial agents used in the treatment of mycoplasmal pneumonia(MP)and provide management recommendations for appropriate clinical drug use.METHODS A comprehensive search was conducted in 3 drug information databases(Micromedex,Lexicomp,and DDInter)to retrieve information on DDIs involving antimicrobial agents used in the guidelines for MP.Each drug was queried individually,and the results were analyzed.RESULTS Multiple interactions were found for all ll antimicrobial agents for treating MP in the 3 databases.Macrolide antibiotics exhibited a higher number of DDIs,requiring particular attention when used concomitantly with medications for patients with comorbidities such as diabetes and hyperlipidemia.Tetracycline antibiotics necessitated consideration of interactions with antiepileptic drugs,and caution was advised when using formulations containing metal cations.Quinolone antibiotics should be monitored for potential DDIs with anticoagulants and acid-suppressing medications.When necessary,treatment regimens should be adjusted,and appropriate monitoring of clinical indicators should be implemented.CONCLUSION DDIs may occur frequently in patients with multiple comorbidities and concurrent use of multiple medications.It is essential for clinicians and pharmacists to adjust treatment regimens and provide appropriate monitoring to avoid adverse drug reactions or treatment failure due to DDIs,thereby promoting rational drug use in clinical practice.