Medication-Related Emergency Department Visits in Pediatrics: a Prospective Observational Study

Zed, Peter J.; Black, Karen; Fitzpatrick, Eleanor; Ackroyd‐Stolarz, Stacy; Murphy, Nancy G.; Curran, Janet; MacKinnon, Neil J.; Sinclair, Douglas

doi:10.1542/peds.2014-1827

Cited by 37 publications

(31 citation statements)

References 58 publications

(32 reference statements)

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“…In case of ambiguous or conflicting events, a third investigators resolved the conflicts by discussing with the reviewers to achieve consensus [49]. …”

Section: Methodsmentioning

confidence: 99%

Medication-related visits in a pediatric emergency department: an 8-years retrospective analysis

et al. 2017

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BackgroundThere are limited data on the characterization of medication-related visits (MRVs) to the emergency department (ED) in pediatric patients in Italy. We have estimated the frequency, severity, and classification of MRVs to the ED in pediatric patients.MethodsWe retrospectively analyzed data for children seeking medical evaluation for a MRV over an 8 years period. A medication-related ED visit was identified by using a random pharmacist assessment, emergency physician assessment, and in case of conflicting events, by a third investigators random assessment.ResultsIn this study, regarding a single tertiary center in Italy, on a total of 147,643 patients from 0 to 14 years old, 497 medication-related visits were found, 54% of which occurred in children from 0 to 2 years of age. Severity was classified as mild in 21.6% of cases, moderate in 67.2% of cases, and severe in 11.2% of cases. The most common events were related to drug use without indication (51%), adverse drug reactions (30.3%), supratherapeutic dosage (13.2%) and improper drug selection (4.5%).The medication classes most frequently implicated in an ADE were anti-infective drugs for systemic use (28.9%), central nervous system agents (22.3%) and respiratory system drugs (10.8%).The most common symptom manifestations were dermatologic conditions (46.1%), general disorder and administration site conditions (29.7%) and gastrointestinal symptoms (16.0%).ConclusionsTo our knowledge, this is the first study in Italy evaluating the epidemiologic characteristics of MRVs confirming a significant cause of healthcare contact resulting in ED visits and hospital admissions with associated resource utilization. Our results suggests further future prospective, large-sample sized, and multicenter research is necessary to better understand the impact of MRVs and to develop strategies to provide care plans and monitor patients to prevent medication-related visits.Trial registrationNot applicable.

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“…In case of ambiguous or conflicting events, a third investigators resolved the conflicts by discussing with the reviewers to achieve consensus [49]. …”

Section: Methodsmentioning

confidence: 99%

Medication-related visits in a pediatric emergency department: an 8-years retrospective analysis

et al. 2017

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“…According to Peter et al, costs of adverse drug‐related events in the United States were estimated to be US$177.4 billion in 2000. Although they are inevitable, learning about ADRs, causes and risk factors will help physicians and pharmacists eliminate, reduce or mange them properly …”

Section: Introductionmentioning

confidence: 87%

Development of biliary and renal stone and sludge after taking Ceftriaxone is associated with a defect in UDP‐Glucuronosyltransferase (ie Gilbert’s syndrome)

et al. 2019

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Background In addition to patient concerns, drug side effects increase health care costs. Although the Ceftriaxone biliary or renal stone and sludge some time is asymptomatic and self‐healing, but some of them are dangerous and may lead to hospitalisation or surgical intervention. Aims Examine the relation between biliary or renal stone and sludge due to ceftriaxone in patients with different variants of UGT1A1 gene. Methods In this cohort study, 176 unrelated infants and children under 12 years of age who receive ceftriaxone were enrolled the study. Each patient before, along treatment and 2 weeks after discharging, follows up with gallbladder and kidneys ultrasonography. Standard blood samples were taken for biochemical and genetic tests. The promoter and exon 1 regions of UGT1A1 gene were sequenced by using Sanger method. All the collected data were analysed by Chi‐squared, one‐way ANOVA, Kruskal‐Wallis, and Mann‐Whitney tests through SPSS Software (version 21). Results Eighty participants (45.5%) were female and the remaining (n = 96; 54.5%) were male. The results showed that 16.5% of participants had abnormal gallbladder conditions. The results suggested that in patients with TA7/7, and Gly71Arg (G/A) genotype (ie Gilbert's syndrome) the prevalence of biliary sludge and stone was significantly higher than the control group (P = 0.008 and 0.05 respectively).

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“…Raziskava Zed PJ in sod. je pokazala, da so neže-leni učinki prejemanja protimikrobnih zdravil med vsemi zdravili najpogostejši vzrok za obisk urgentne ambulante zaradi neželenih učinkov zdravil (29). Vedno, ko predpišemo antibiotik, je potrebno pomisliti tudi na morebitne dolgoročne neželene učinke antibiotikov.…”

Section: Izvirni Znanstveni čLanekunclassified

Ambulantna poraba antibiotikov pri otrocih v Sloveniji

et al. 2017

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Background: Antibiotics are among the most common drugs prescribed in outpatient settings. It is estimated that up to 50 % are prescribed unnecessarily or inappropriately. To plan the actions for optimizing the use of antibiotics, we conducted a national antibiotic consumption study in children aged 0–18 years in the period between 2003 and 2015.Methods: In this national retrospective research we analyzed outpatient antibiotic consumption using ATC/DDD classification. The use of antibiotics was recorded in relation to the pattern of prescription, age, gender and health region.Results: The total consumption of antibiotics decreased by 35 % from 979 to 636 prescriptions per 1000 children/year (PTY) during the whole study period. Te use of all antibiotic classes decreased (except for quinolones and nitrofuran derivatives) by 12.5 %–81 %. In all those years we recorded the highest consumption in children aged 1 to 4 years (2184–1160 PTY). Amoxicillin was the most commonly prescribed antibiotic in children aged 0 to 4 years, penicillin V among 5 to 14 years and co-amoxiclav among adolescents aged 15 to 19 years. In health regions in the northeastern part of Slovenia much more antibiotics were prescribed than in other regions. In 2015, 65 % of prescriptions were prescribed by pediatricians and school medicine specialists, 16 % by physicians without specialization, 14 % by GPs/family doctors and 5 % by other specialists.Conclusions: Despite the decrease in outpatient antibiotic use in children and adolescents in Slovenia, the overall and especially broad-spectrum antibiotic consumption (amoxicillin with clavulanic acid, azithromycin and second/third generation cephalosporins) is still too high. It is necessary to strengthen activities to reduce prescribing, particularly for acute (upper) respiratory tract infections.

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Medication-Related Emergency Department Visits in Pediatrics: a Prospective Observational Study

Cited by 37 publications

References 58 publications

Medication-related visits in a pediatric emergency department: an 8-years retrospective analysis

Medication-related visits in a pediatric emergency department: an 8-years retrospective analysis

Development of biliary and renal stone and sludge after taking Ceftriaxone is associated with a defect in UDP‐Glucuronosyltransferase (ie Gilbert’s syndrome)

Ambulantna poraba antibiotikov pri otrocih v Sloveniji

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