Causality and avoidability of adverse drug reactions of antibiotics in hospitalized children: a cohort study

Ramos, Sheila Feitosa; Araújo-Neto, Fernando de Castro; Aires-Moreno, Giulyane Targino; Araújo, Dyego Carlos Souza Anacleto de; Lima, Elisângela da Costa; Lyra, Divaldo Pereira de

doi:10.1007/s11096-021-01249-8

Cited by 8 publications

(7 citation statements)

References 52 publications

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“…As positive aspects, we can mention the use of the Liverpool tool (LCAT), a flow diagram designed by a multidisciplinary team to be quick and easy to use,13 and which is more objective than previous methods, transparent and can be used by individuals or groups 14. Those characteristics allow a better assessment of suspected reactions and the sample size, which is larger than that observed in other studies with active search in pediatric patients 7…”

Section: Discussionmentioning

confidence: 99%

“…The length of stay is related to the characteristics of the hospital, the population served and the type and severity of the disease 4. The longer the hospital stay, the greater the exposure to medications and, consequently, the greater risk of developing ADRs, medication errors, microbial resistance, nosocomial infection and hospitalisation costs 7…”

Section: Discussionmentioning

confidence: 99%

“…The main classes of drugs commonly associated with ADR in pediatric patients are analgesics, antimicrobials and corticosteroids 6. Recent studies also bring attention to the frequent occurence of ADRs with antimicrobials,7 a drug class widely used in children during hospitalisation 8…”

Section: Introductionmentioning

confidence: 99%

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Adverse reactions to antimicrobials in pediatric patients admitted to a tertiary hospital: a cohort study

et al. 2023

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BackgroundAntimicrobials are widely used in hospitals and are often associated with adverse drug reactions (ADRs). The objective of this study was to determine the incidence of ADRs caused by antimicrobials and classify them according to the type of reaction, the class of antimicrobials used, causality, severity and avoidability.MethodsA prospective cohort study was carried out with paediatric patients for 6 months. Causality was verified using the Naranjo and Liverpool algorithms, the severity was verified with the adapted scale of Hartwig and the avoidability was verified with the Liverpool Avoidability Assessment Tool.ResultsA total of 303 patients were followed, and 18.2% (55/303) of them had one or more ADRs during the hospital stay. Just over half of the patients (28/55) had diarrhea. The most used antimicrobials were beta-lactams and second-generation cephalosporins. Suspicions were classified mainly as possible 78.6% (55/70) according to the Naranjo algorithm, and as probable 48.6% (34/70) according to the Liverpool algorithm. The antimicrobial most involved with ADRs was cefepime. The risk of manifesting ADR was greater with the use of some antimicrobials such as clindamycin (relative risk (RR) 3.0, CI 1.67 to 5.4), as well as with the increase in hospitalisation days (OR 1.022, CI 1.008 to 1.036) and in the number of antimicrobials prescribed (OR 1.649, CI 1.360 to 2.001).ConclusionADRs were observed in approximately one-fifth of patients and were mostly gastrointestinal, moderate, unavoidable and with variable causality, depending on the algorithm used.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Adverse reactions to antimicrobials in pediatric patients admitted to a tertiary hospital: a cohort study

et al. 2023

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“…ADRs in children may differ from those in adults due to age-dependent pharmacokinetics and pharmacodynamics of drugs. Further, children are often prescribed medications that are off-label putting them at a greater risk potentially for ADRs [1][2][3]. The majority of the time, postmarketing surveillance remains the predominant way to detect ADRs specific to children.…”

Section: Introductionmentioning

confidence: 99%

“…Hence, it is important to identify ADRs to drugs used in the treatment of diseases endemic to this country. Though children constitute 40% of the population of India, information regarding ADRs, the drugs involved, and the clinical presentations in this age group, are scanty [2][3][4]. ADRs can result in unplanned hospital outpatient visits, unplanned hospital admission, and economic losses to the health service system [2].…”

Section: Introductionmentioning

confidence: 99%

Causality, Severity, and Avoidability of Adverse Drug Reactions in Hospitalized Children: A Prospective Cohort Study

Gupta¹,

Zaki²,

Masavkar³

et al. 2023

Cureus

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Background: Adverse drug reactions are an important cause of morbidity and mortality in all patients. Information regarding adverse drug reactions in the pediatric age group, especially with regard to the drugs involved and the clinical presentations is scanty. The aim of our study is to determine the incidence of adverse drug reactions and to study their features in terms of causality, type, severity, avoidability, drugs implicated and their clinical presentations.Methods: The study was carried out on patients admitted to the pediatric ward and the pediatric intensive care unit over a one-year period (January 1, 2013 to December 31, 2013). Patients either presenting with or developing an adverse drug reaction in the hospital were included in the study.Results: The incidence rate for adverse drug reaction causing hospital admission was 1.79% (95% CI 1.48, 2.16) whereas it was 1.23% (95% CI 0.97, 1.53) for children exposed to a drug during their hospital stay. Type B (bizarre or idiosyncratic type) was seen in 114 (62.6%) of the ADRs whereas 53 (29.1%) were of type A (augmented pharmacologic effect). Severe ADRs were seen in 25 (13.7%) of the total ADRs. ADR was responsible for the death of two patients. 15.4% were rated as avoidable. Anti-microbials were the most common group responsible for ADRs (43.4%), followed by drugs acting on the immune system (15.9%) and drugs acting on the nervous system (14.3%). The most common ADRs were metabolic (29.3%) followed by neurological (17.6%).Conclusions: Adverse drug reactions can occur in a substantial proportion of hospitalized patients with some of them being severe and potentially avoidable. Awareness among physicians should be encouraged regarding monitoring, documentation and notification of adverse drug reactions.

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MOFFeCo/B-CN composites achieve efficient degradation of antibiotics in a non-homogeneous concurrent photocatalytic-persulfate activation system

Wang

Reddy³

et al. 2023

Science of The Total Environment

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Causality and avoidability of adverse drug reactions of antibiotics in hospitalized children: a cohort study

Cited by 8 publications

References 52 publications

Adverse reactions to antimicrobials in pediatric patients admitted to a tertiary hospital: a cohort study

Adverse reactions to antimicrobials in pediatric patients admitted to a tertiary hospital: a cohort study

Causality, Severity, and Avoidability of Adverse Drug Reactions in Hospitalized Children: A Prospective Cohort Study

MOFFeCo/B-CN composites achieve efficient degradation of antibiotics in a non-homogeneous concurrent photocatalytic-persulfate activation system

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