Investigation of potential interactions between multi-DRUG USE, antimicrobials and other drugs in patients with hematological malignities

Purpose: This thesis was intended to examine the potential interactions between polypharmacy, antimicrobials and other drugs in patients with hematological malignancies and the consequences of these interactions. Method: The drugs used by 233 patients with hematological malignancies who received in-patient treatment for more than two days between January 2021 and July 2021 in the wards of Ankara City Hospital Hematology Clinic, before and during hospitalization were examined. Clinical, demographic and laboratory data of patients using polypharmacy and non-users were compared. Interactions between drugs were observed through UptoDate, Drugs.com and MedScape databases. It was recorded whether major interactions between antimicrobials and other drugs had clinical implications in patients. SPSS R version 4.0.2 was used for statistical analysis of the data, p<0.05 was considered significant. Results: The mean age of the patients participating in the study was 56.7±16.5 years. The prevalence of polypharmacy before hospitalization was determined as 22.7%. Antimicrobial use was found to be related to multiple drug use (p<0.001). In patients diagnosed with acute leukemia and MM, statistically significantly more drug use (p<0.001) and more antimicrobial-related potential interactions were detected during hospitalization (p<0.001). 9.2% (70/758) of major antimicrobial-related interactions detected in the three interaction systems were observed as the clinical reflection in 18% (42/233) of the patients participating in the study. It was determined that the patients with clinical reflection were hospitalized for a statistically significant longer period, the total number of drugs used, and the number of drugs taken at the same time were higher (p<0.001, p<0.001, p<0.001, respectively). Besides, it was observed that antimicrobial-related major interactions detected in patients using amikacin, ciprofloxacin and clarithromycin had a higher clinical reflection (p<0.001, p=0.004, p=0.021, p=0.012, respectively). Conclusion: Interactions between antimicrobials and other drugs are undesirable problems. There must be more studies carried out to evaluate the clinical and economic effects of the interactions on patients with hematological and non-hematological malignancies. Keywords: Polypharmacy, Hematological Malignancies, Drug interaction