고령자에서 Sulfonylureas와 항균제의 병용투여 현황

Abstract

Background: Previous studies have noted that the simultaneous use of sulfonylureas and antimicrobials, which is common, couldincrease the risk of hypoglycemia. In particular, an age of 65 years or older is a known risk factor for sulfonylurea-relatedhypoglycemia in hospitalized patients. Therefore, we performed this study to determine the potential risk of hypoglycemia from theconcurrent use of antimicrobials and sulfonylureas. Methods: We performed a cross-sectional study on the National HealthInsurance Service-National Sample Cohort from 2013. The eligibility criteria included patients of 65 years of age or older taking asulfonylurea with 25 different antimicrobials. Different risk ratings of severity in drug-drug interactions (potential DDIs), level X, D, orC in Lexi-Interact™online, and contraindicated, major, or moderate severity level in Micromedex® were included. SAS version 9.4was used for data analysis. Results: A total of 6,006 elderly patients with 25,613 prescriptions were included. The largest age groupwas 70 to 74 (32.7%), and 39.7% of patients were men. The mean number of prescriptions was 4.3 per patient. The most frequentlyused antimicrobials were levofloxacin (6,583, 25.7%), ofloxacin (6,549, 25.6%), fluconazole (4,678, 18.0%), and ciprofloxacin (2,551,9.8%). Among sulfonylureas, glimepiride was prescribed most frequently, followed by gliclazide, glibenclamide, and glipizide. Conclusion: Of the antimicrobials with a high potential of hypoglycemia, levofloxacin, ofloxacin, fluconazole, and ciprofloxacin wereused frequently. Thus, the monitoring of clinically relevant interactions is required for patients concurrently administered sulfonylureasand antimicrobials.