{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:15:52Z","timestamp":1790270152264,"version":"4.1.0"},"reference-count":81,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,10,31]],"date-time":"2021-10-31T00:00:00Z","timestamp":1635638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Patients in intensive care units (ICUs) are at high risk of drug\u2013drug interactions (DDIs) due to polypharmacy. Little is known about type and frequency of DDIs within German ICUs. Clinical pharmacists\u2019 interventions (PI) recorded in a national database (ADKA-DokuPIK) were filtered for ICU patients. Binary DDIs involving \u22651 anti-infective agent with &gt;1 database entry were selected. A modified two-step Delphi process with a group of senior hospital pharmacists was employed to evaluate selected DDIs for clinical relevance by using a five-point scale and to develop guidance for clinical practice. In total, 16,173 PI were recorded, including 1836 (11%) DDIs in the ICU setting. Of the latter, 41% (756\/1836) included \u22651 anti-infective agent, 32% (590\/1836) were binary DDIs, and 25% (455\/1836) were listed at least twice. This translates into 88 different DDIs, 74% (65\/88) of which were rated as being clinically relevant by our expert panel. The majority of DDIs (76% [67\/88]) included macrolides, antifungals, or fluoroquinolones. This percentage was even higher in DDIs being rated as clinically relevant by the experts (85% [55\/65]). It is noted that an inter-professional discussion and approach is needed in the individual patient management of DDIs. The guidance developed might be a tool for decision support.<\/jats:p>","DOI":"10.3390\/antibiotics10111330","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T11:47:38Z","timestamp":1635767258000},"page":"1330","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Clinically Relevant Interactions with Anti-Infectives on Intensive Care Units\u2014A Multicenter Delphi Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0101-2102","authenticated-orcid":false,"given":"Joachim Andreas","family":"Koeck","sequence":"first","affiliation":[{"name":"Committee for Intensive Care Medicine and Clinical Nutrition, German Association of Hospital Pharmacists (ADKA), 10559 Berlin, Germany"},{"name":"Department of Intensive Care and Intermediate Care, RWTH Aachen University Hospital, 52074 Aachen, Germany"},{"name":"Hospital Pharmacy, RWTH Aachen University Hospital, 52074 Aachen, Germany"},{"name":"Institute of Clinical Pharmacology, RWTH Aachen University Hospital, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4126-4251","authenticated-orcid":false,"given":"Heike","family":"Hilgarth","sequence":"additional","affiliation":[{"name":"Committee for Intensive Care Medicine and Clinical Nutrition, German Association of Hospital Pharmacists (ADKA), 10559 Berlin, Germany"},{"name":"Committee for Pharmacists\u2019 Interventions, German Association of Hospital Pharmacists (ADKA), 10559 Berlin, Germany"},{"name":"Hospital Pharmacy, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"},{"name":"Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"von Ameln-Mayerhofer","sequence":"additional","affiliation":[{"name":"Committee for Intensive Care Medicine and Clinical Nutrition, German Association of Hospital Pharmacists (ADKA), 10559 Berlin, Germany"},{"name":"Hospital Pharmacy, Sindelfingen-Boeblingen Medical Center, 71065 Sindelfingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damaris","family":"Meyn","sequence":"additional","affiliation":[{"name":"Committee for Intensive Care Medicine and Clinical Nutrition, German Association of Hospital Pharmacists (ADKA), 10559 Berlin, Germany"},{"name":"Hospital Pharmacy, Gesundheit Nordhessen Holding AG, 34121 Kassel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruediger","family":"Warlich","sequence":"additional","affiliation":[{"name":"Committee for Intensive Care Medicine and Clinical Nutrition, German Association of Hospital Pharmacists (ADKA), 10559 Berlin, Germany"},{"name":"Hospital Pharmacy, Sana Medical Center Offenbach, 63069 Offenbach, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"M\u00fcnstedt","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy, University Hospital Muenster, 48149 Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagmar","family":"Horn","sequence":"additional","affiliation":[{"name":"Committee for Intensive Care Medicine and Clinical Nutrition, German Association of Hospital Pharmacists (ADKA), 10559 Berlin, Germany"},{"name":"Hospital Pharmacy, University Hospital Muenster, 48149 Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3354-3496","authenticated-orcid":false,"given":"Christina","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Committee for Intensive Care Medicine and Clinical Nutrition, German Association of Hospital Pharmacists (ADKA), 10559 Berlin, Germany"},{"name":"Hospital Pharmacy, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"},{"name":"Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,31]]},"reference":[{"key":"ref_1","first-page":"452","article-title":"Drug interactions and adverse events induced by drugs used in an intensive care unit","volume":"138","author":"Plaza","year":"2010","journal-title":"Revista Medica de Chile"},{"key":"ref_2","first-page":"495","article-title":"Interventions of a clinical pharmacist in a medical intensive care unit\u2014A retrospective analysis","volume":"20","author":"Cvikl","year":"2020","journal-title":"Bosn. 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