Adverse Drug Reactions Causing Admission to a Paediatric Hospital

作者：Gallagher Ruairi M^*; Mason Jennifer R; Bird Kim A; Kirkham Jamie J; Peak Matthew; Williamson Paula R; Nunn Anthony J; Turner Mark A; Pirmohamed Munir; Smyth Rosalind L

来源：PLos One, 2012, 7(12): e50127.

DOI：10.1371/journal.pone.0050127

Objective(s): To obtain reliable information about the incidence of adverse drug reactions, and identify potential areas where intervention may reduce the burden of ill-health. %26lt;br%26gt;Design: Prospective observational study. %26lt;br%26gt;Setting: A large tertiary children%26apos;s hospital providing general and specialty care in the UK. %26lt;br%26gt;Participants: All acute paediatric admissions over a one year period. %26lt;br%26gt;Main Exposure: Any medication taken in the two weeks prior to admission. %26lt;br%26gt;Outcome Measures: Occurrence of adverse drug reaction. %26lt;br%26gt;Results: 240/8345 admissions in 178/6821 patients admitted acutely to a paediatric hospital were thought to be related to an adverse drug reaction, giving an estimated incidence of 2.9% (95% CI 2.5, 3.3), with the reaction directly causing, or contributing to the cause, of admission in 97.1% of cases. No deaths were attributable to an adverse drug reaction. 22.1% (95% CI 17%, 28%) of the reactions were either definitely or possibly avoidable. Prescriptions originating in the community accounted for 44/249 (17.7%) of adverse drug reactions, the remainder originating from hospital. 120/249 (48.2%) reactions resulted from treatment for malignancies. The drugs most commonly implicated in causing admissions were cytotoxic agents, corticosteroids, non-steroidal anti-inflammatory drugs, vaccines and immunosuppressants. The most common reactions were neutropenia, immunosuppression and thrombocytopenia. %26lt;br%26gt;Conclusions: Adverse drug reactions in children are an important public health problem. Most of those serious enough to require hospital admission are due to hospital-based prescribing, of which just over a fifth may be avoidable. Strategies to reduce the burden of ill-health from adverse drug reactions causing admission are needed. Citation: Gallagher RM, Mason JR, Bird KA, Kirkham JJ, Peak M, et al. (2012) Adverse Drug Reactions Causing Admission to a Paediatric Hospital. PLoS ONE 7(12): e50127. doi: 10.1371/journal.pone.0050127

• 出版日期2012-12-4