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Potential drug interactions in travelers with chronic illnesses: a large retrospective cohort study.
Travel Med Infect Dis. 2014 Sep-Oct; 12(5):499-504.TM

Abstract

BACKGROUND

Data regarding the prevalence of potential interactions between travel-related medications (TRM) and chronic medications in use, or medical conditions of travelers to developing countries are limited.

METHODS

A retrospective cohort study of travelers to low income countries. We extracted data on demographics, travel destinations, use of chronic medications, drug allergies, and relevant medical conditions. The following TRM were evaluated: mefloquine, primaquine, doxycycline, atovaquone/proguanil, fluoroquinolone antibiotics, rifaximin, azithromycin, and acetazolamide.

RESULTS

A total of 16,263 travelers were included in the analysis, of whom 3299(20%) suffered from chronic illnesses and 2316(14%) reported chronic medication use. A potential drug-drug interaction with TRM was identified in 1047(45%) of travelers using chronic medication. Fluoroquinolones and azithromycin were the most commonly implicated TRMs. A potential medical condition interaction with TRM was identified in 717(22%) of travelers having chronic illnesses. acetazolamide, primaquine and mefloquine, were the most commonly TRMs implicated. Drug allergies, which can pose a relative contraindication for use of acetazolamide, were reported by 1323(8.1%) of all travelers.

CONCLUSIONS

Potential drug-drug and drug-disease interactions involving TRM might occur in a significant proportion of travelers with chronic medical conditions. Education of health practitioners regarding such potential drug interactions and caution when in prescribing travel-related medications is warranted.

Authors+Show Affiliations

The Center of Geographic Medicine, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel; The Departments of Internal Medicine, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel; The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel. Electronic address: sshmuel@netvision.net.il.The Center of Geographic Medicine, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel; The Departments of Internal Medicine, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel; The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel. Electronic address: meltzere@zahav.net.il.The Departments of Internal Medicine, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel; The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel. Electronic address: d_Kurnik@rambam.health.gov.il.The Center of Geographic Medicine, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel; The Departments of Internal Medicine, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel; The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel. Electronic address: leshem@gmail.com.The Center of Geographic Medicine, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel; The Departments of Internal Medicine, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. Electronic address: eran.kopel@mail.huji.ac.il.The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; The Arrow Project, The Chaim Sheba Medical Center, Tel Hashomer, 52621, Israel. Electronic address: biana.str@gmail.com.The Center of Geographic Medicine, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel; The Departments of Internal Medicine, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel; The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel. Electronic address: elischwa@post.tau.ac.il.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24867407

Citation

Stienlauf, Shmuel, et al. "Potential Drug Interactions in Travelers With Chronic Illnesses: a Large Retrospective Cohort Study." Travel Medicine and Infectious Disease, vol. 12, no. 5, 2014, pp. 499-504.
Stienlauf S, Meltzer E, Kurnik D, et al. Potential drug interactions in travelers with chronic illnesses: a large retrospective cohort study. Travel Med Infect Dis. 2014;12(5):499-504.
Stienlauf, S., Meltzer, E., Kurnik, D., Leshem, E., Kopel, E., Streltsin, B., & Schwartz, E. (2014). Potential drug interactions in travelers with chronic illnesses: a large retrospective cohort study. Travel Medicine and Infectious Disease, 12(5), 499-504. https://doi.org/10.1016/j.tmaid.2014.04.008
Stienlauf S, et al. Potential Drug Interactions in Travelers With Chronic Illnesses: a Large Retrospective Cohort Study. Travel Med Infect Dis. 2014;12(5):499-504. PubMed PMID: 24867407.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Potential drug interactions in travelers with chronic illnesses: a large retrospective cohort study. AU - Stienlauf,Shmuel, AU - Meltzer,Eyal, AU - Kurnik,Daniel, AU - Leshem,Eyal, AU - Kopel,Eran, AU - Streltsin,Bianca, AU - Schwartz,Eli, Y1 - 2014/05/05/ PY - 2014/02/28/received PY - 2014/04/09/revised PY - 2014/04/24/accepted PY - 2014/5/29/entrez PY - 2014/5/29/pubmed PY - 2015/3/31/medline KW - Chronic disease KW - Chronic use of prescription drugs KW - Developing countries KW - Drug interactions KW - Israel KW - Travelers SP - 499 EP - 504 JF - Travel medicine and infectious disease JO - Travel Med Infect Dis VL - 12 IS - 5 N2 - BACKGROUND: Data regarding the prevalence of potential interactions between travel-related medications (TRM) and chronic medications in use, or medical conditions of travelers to developing countries are limited. METHODS: A retrospective cohort study of travelers to low income countries. We extracted data on demographics, travel destinations, use of chronic medications, drug allergies, and relevant medical conditions. The following TRM were evaluated: mefloquine, primaquine, doxycycline, atovaquone/proguanil, fluoroquinolone antibiotics, rifaximin, azithromycin, and acetazolamide. RESULTS: A total of 16,263 travelers were included in the analysis, of whom 3299(20%) suffered from chronic illnesses and 2316(14%) reported chronic medication use. A potential drug-drug interaction with TRM was identified in 1047(45%) of travelers using chronic medication. Fluoroquinolones and azithromycin were the most commonly implicated TRMs. A potential medical condition interaction with TRM was identified in 717(22%) of travelers having chronic illnesses. acetazolamide, primaquine and mefloquine, were the most commonly TRMs implicated. Drug allergies, which can pose a relative contraindication for use of acetazolamide, were reported by 1323(8.1%) of all travelers. CONCLUSIONS: Potential drug-drug and drug-disease interactions involving TRM might occur in a significant proportion of travelers with chronic medical conditions. Education of health practitioners regarding such potential drug interactions and caution when in prescribing travel-related medications is warranted. SN - 1873-0442 UR - https://www.unboundmedicine.com/medline/citation/24867407/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1477-8939(14)00082-9 DB - PRIME DP - Unbound Medicine ER -