Objective  To describe the prevalence of potential drug-drug interactions (pDDIs) involving antimicrobial agents in the ICU and analyze the role of clinical pharmacist interventions in improving the safety and effectiveness of antimicrobial agents use in ICU patients.

Methods  A prospective study was conducted to select ICU patients whose medical prescriptions were reviewed by clinical pharmacists in The Second Affiliated Hospital of Xi'an Jiaotong University from January to December 2021, as the intervention group, and the patients with ICU infections in this hospital who did not undergo pharmacy intervention from January to December 2019, were retrospectively selected as the control group. The hospital stay in ICU and the incidence of antimicrobial drug-associated hepatic and renal injuries of the patients with infections with or without the intervention of clinical pharmacists were compared. The intervention group utilized the Micromedex database to identify and analyze the severity and clinical significance of pDDIs.

Results  A total of 778 patients were included, with 406 patients in the intervention group. Clinical pharmacists reviewed 3 619 medication orders and identified 30 combinations of drug interactions, resulting in 286 pDDIs, with 10 combinations accounting for 60.5% of observed pDDIs. According to statistical analysis, there was a statistically significant difference between the categories of antimicrobial drugs and the average number of drug varieties used (P<0.01). Clinical pharmacists intervened in 537 cases of pDDIs, of which 503 were accepted by physicians, resulting in an overall acceptance rate of 93.7%. Compared to the control group, patients in the intervention group had significantly shorter ICU stays and a decreased incidence of antimicrobial-related hepatic and renal injuries (P<0.05).

Conclusion  The occurrence of pDDIs is relatively high among ICU infection patients, and drug therapy is susceptible to the influence of drug interactions. Clinical pharmacist interventions can prevent or manage pDDIs, thereby improving the safety and effectiveness of antimicrobial drug use in ICU patients.

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