Characterization of serious adverse drug reactions as cause of emergency
department visit in children: a 5-years active pharmacovigilance study
#MMPMID29661234
Lombardi N
; Crescioli G
; Bettiol A
; Marconi E
; Vitiello A
; Bonaiuti R
; Calvani AM
; Masi S
; Lucenteforte E
; Mugelli A
; Giovannelli L
; Vannacci A
BMC Pharmacol Toxicol
2018[Apr]; 19
(1
): 16
PMID29661234
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BACKGROUND: To describe frequency, preventability and seriousness of adverse drug
reactions (ADRs) in children as cause of emergency department (ED) admission and
to evaluate the association between specific factors and the reporting of ADRs.
METHODS: A retrospective analysis based on reports of suspected ADRs collected
between January 1st, 2012 and December 31st, 2016 in the ED of Meyer Children's
Hospital (Italy). Demographics, clinical status, suspected drugs, ADR
description, and its degree of seriousness were collected. Logistic regression
was used to estimate the reporting odds ratios (RORs) with 95% confidence
intervals (CIs) of potential predictors of ADR seriousness. RESULTS: Within
5 years, we observed 834 ADRs (1100 drug-ADR pairs), of whom 239 were serious; of
them, 224 led to hospitalization. Patients were mostly treated with one drug.
Among patients treated with more than one drug, 78 ADRs presented a potential
interaction. The most frequently reported ADRs involved gastrointestinal system.
The most frequently reported medication class was antinfectives. Risk of serious
ADR was significantly lower in children and infants compared to adolescents (ROR
0.41 [95% CI: 0.27-0.61] and 0.47 [0.32-0.71], respectively), and it was
significantly increased in subjects exposed to more than one drug (ROR 1.87
[1.33-2.62] and 3.01 [2.07-4.37] for subjects exposed to 2 and 3 or more drugs,
respectively). Gender, interactions and off-label drug use did not influence the
risk of serious ADRs. CONCLUSION: Active surveillance in pharmacovigilance might
represent the best strategy to estimate and characterize the clinical burden of
ADRs in children.
|Adolescent
[MESH]
|Child
[MESH]
|Child, Preschool
[MESH]
|Drug-Related Side Effects and Adverse Reactions/*epidemiology
[MESH]
|Emergency Service, Hospital/*statistics & numerical data
[MESH]
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