Only 93 items were included for the determination of potential DDIs by Micromedex,, and Liverpool HIV interactions (Fig. However, 21 items were not recognised by one of the three databases, Micromedex (diethylcarbamazine, fusidic acid, protionamide, and sulbactam), (delamanid, diethylcarbamazine, fusidic acid, protionamide, and sulbactam), and Liverpool (artesunate, cefoperazone, cefoxitin, cefuroxime, colistimethate, dicloxacillin, fosfomycin, fusidic acid, micafungin, neomycin, netilmicin, norfloxacin, peramivir, protionamide, roxithromycin, saturated solution of potassium iodide, sulbactam, trimethoprim, and tuberculin purified protein derivative). Of the 645 total items, only 114 items were antiretrovirals and antimicrobials. ![]() This study was conducted from 1 to 31 October 2020. Furthermore, the ability and agreement of the databases was considered in order to find the most suitable information for health care providers and HIV patients to optimise drug regimens.Īll antiretrovirals and antimicrobials were selected from the NLEM of Thailand 2018 19. Liverpool HIV interaction database focused mainly on HIV drugs was selected into this study in order to determine the ability and agreement of the three electronic databases in detecting potential DDIs of antiretrovirals and antimicrobials in the national list of essential medicines of Thailand (NLEM, 2018). ![]() Interestingly, there is a specialised database commonly used to determine DDIs of HIV medicines in HIV community. This has resulted in differences in the identification and management of DDIs. However, several reports have mentioned that the potential DDIs detected by Micromedex and have low to moderate agreement 17, 18. In contrast, is a free online database, favoured by patients to identify potential DDIs, as well as some pharmacists who do not subscribe to the paid database. This database is subject to annual subscription fees, either individually or institutionally. The most popular database for healthcare providers seems to be Micromedex, provided by IBM Corp., USA. Recently, electronic DDIs databases were introduced to determine potential DDIs in the prescription of HIV infected patients 15, 16. There is a challenge in the selection of drug regimens to maximise the efficacy and minimise the toxicity of ART and antimicrobial usage in HIV patients. The addition of antimicrobials for opportunistic infections may increase the risk of DDIs 13, 14. Additionally, the progression of HIV infection can lead to opportunistic infections for which further medications would be prescribed 11, 12. These DDIs can interfere with antiretroviral efficacy, safety, and patient compliance, and thereby lead to treatment failure 9, 10. Consequently, several drug-drug interactions (DDIs) and adverse events have been reported in the combination of ART 7, 8. Therefore, antiretroviral therapy (ART) has been introduced for HIV treatment in order to maintain the immunity of HIV infected patients 5, 6. HIV infection can result in the deterioration of the immune system and lead to opportunistic infections 3, 4. ![]() The human immunodeficiency virus (HIV) is a lentivirus that causes HIV infection and acquired immunodeficiency syndrome (AIDS) 1, 2. This study highlights the need to harmonize the evaluation and interpretation of DDI risk in order to produce standardized information to support prescribers. The Fleiss’ kappa agreements were fair to poor among the three databases, higher agreement was observed for DDIs classified as severe. Regarding the severity classifications, Liverpool reported 10% Contraindicated Micromedex reported 14% contraindicated and 59% major reported 21% major. Liverpool showed the highest number of DDIs with 285 pairs compared with 259 pairs by and 133 pairs by Micromedex. Potential DDIs detected from the three databases included 292 pairs. Only 93 items were available for the detection of potential DDIs by the three databases. However, 21 items were not recognised by Micromedex,, and Liverpool HIV interactions. 114 items of antiretrovirals and antimicrobials from the National List of Essential Medicines of Thailand 2018 were used in the study. The objective of this study was to to compare the recognition of DDIs between antiretrovirals and antimicrobials by three proprietary databases and evaluate their concordance. ![]() Additionally, opportunistic infections in HIV infected patients require further antimicrobial medications that might cause drug-drug interactions (DDIs). Standard treatment for HIV infection involves a combination of antiretrovirals.
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