Objectives: Antifungal drugs are often taken for a long period of time and are capable of interacting with a wide range of other medications e.g. the azole group of antifungals are a substrate and inhibitor of cytochrome P450 (CYP) which is important for the elimination of many other drugs. These interactions can in some cases cause serious alterations in the effective dose of either the antifungal drug or the concomitant medication. Doctors and pharmacists experience with oral or IV antifungal drugs can be limited so information provided to the patient on possible interactions runs the risk of being incomplete. In addition several antifungals have not been in use fpr a long time and new interactions are still being discovered. There is a need for a single central resource to hold all interaction data for this class of drugs. Method: The Aspergillus Website is one of the best used and most highly ranked websites that provide information on the treatment of aspergillosis and support to patients. The website is run by a team closely associated with the National Aspergillosis Centre (NAC), Manchester, UK. It therefore has ready access to relevant clinical advice and is already established as a well used route of communication for medical information and support for aspergillosis. We set out to provide a database in which all currently known interactions with antifungal drugs are recorded. A four level colour system is used and designed for patients; white - no interaction, green - minor interaction, orange - moderate interaction, needs medical input and red - significant interaction, needs urgent medical assessment. The text related to each interaction explains the reason for the interaction and suggests ways of circumventing it. Addition of new information is a regular ongoing process using new scientific papers and our own clinical experience at the NAC as a guide. Results: We launched the Antifungal Drug Interaction database (www.aspergillus.org.uk/nac/interactions/patientchoosegeneric.php) in July 2011 with 708 concomitant drugs and six antifungals covered; itraconazole, voriconazole, posaconazole, micafungin, amphotericin B and caspofungin. In its first three months of operation the database was used over 1300 times. Conclusions: The Antifungal Drug Interactions database has been well received, suggesting that it is useful and easy to use, and that the information is a valuable addition to the support we offer patients and doctors.
Full conference title:
22nd European Congress of Clinical Microbiology and Infectious Diseases
- ECCMID 22nd (2012)