Shmuel Stienlauf1, Eyal Meltzer2, Daniel Kurnik3, Eyal Leshem4, Eran Kopel5, Bianca Streltsin6, Eli Schwartz7. 1. 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. 2. 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. 3. 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. 4. 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. 5. 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. 6. 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. 7. 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.
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.
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: Nadine Sbaih; Brian Buss; Dheeraj Goyal; Sowmya R Rao; Russell Benefield; Allison Taylor Walker; Douglas H Esposito; Edward T Ryan; Regina C LaRocque; Daniel T Leung Journal: Open Forum Infect Dis Date: 2018-10-22 Impact factor: 3.835