Hassanzad M, et al. – This study outlined the rate, pattern, risk factors, and management of potential drug–drug interactions (pDDIs) in the pediatric intensive care unit (PICU). Evidence suggested that the existence of pDDIs was significantly associated with the number of prescribed medications. Moreover, exposure to pDDIs was frequent in critically ill pediatric patients and related to the number of medications. Thus, to prevent harmful outcomes of DDIs, daily and close cooperation between clinicians and clinical pharmacologists was recommended.

• An observational study was conducted for 6 months. 
• By a clinical pharmacologist, pharmacotherapy data of PICU–admitted patients were evaluated.
• With the aid of Lexi–Interact database, interacting drugs, reliability, mechanism, potential outcome, and clinical management of pDDIs were identified.
• Logistic regression was applied to analyze the risk factors that could be associated with the interactions.
• During the study period, 123 medication profiles were evaluated.
• Diseases of the respiratory system were the main diagnoses among intensive care unit (ICU)–admitted patients (56.1%).
•  A total of 38.6% of the patients exposed to at least 1 major and/or contraindicated interaction during ICU admission.
•  Most pDDIs occurred through metabolic (35.4%) and additive (34.8%) mechanisms.