PEDIATRICS Vol. 82 No. 1 July 1988, pp. 24-29
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Adverse Drug Reactions in Children Leading to Hospital Admission

Allen A. Mitchell MD1, Peter G. Lacouture PhD1, Jane E. Sheehan RN, MS1, Ralph E. Kauffman MD1, and Samuel Shapiro MB, FRCP(E)1

1 From the Pediatric Drug Surveillance Program, Slone Epidemiology Unit, Boston University School of Public Health; Division of Clinical Pharmacology and Toxicology, Children's Hospital, Harvard Medical School, Boston; and Departments of Pediatrics and Pharmacology, Wayne State University, Children's Hospital of Michigan, Detroit

To provide information regarding pediatric hospital admissions prompted by adverse drug reactions, data were reviewed from an intensive drug surveillance program in which 10,297 patients admitted to diverse pediatric wards at four teaching and three community hospitals were systematically monitored. Among 3,026 neonatal intensive care unit admissions, 0.2% were prompted by adverse drug reactions; among 725 children with cancer, 22% of admissions were prompted by adverse drug reactions. Among 6,546 children with other conditions monitored on general medical and specialty wards at two teaching hospitals and on general pediatric wards at three community hospitals, 2% (131) of admissions were prompted by adverse drug reactions. Two patients (0.03%) died because of their reactions. The proportion of admissions prompted by drug reactions increased between infancy and 5 years of age and tended to be relatively stable thereafter. The drugs most commonly implicated in the admissions were phenobarbital, aspirin, phenytoin, ampicillin/amoxicillin, theophylline/aminophylline, trimethoprim-sulfamethoxazole, and diphtheria-pertussis-tetanus vaccine. Similar proportions of admissions were prompted by adverse drug reactions in teaching hospitals (2.1%) and in community hospitals (1.8%), and the drug groups implicated in these admissions were generally similar in the two settings. In contrast to adult populations, children with adverse drug reactions account for a small proportion of hospital admissions. Findings from this large, systematic study of pediatric admissions to teaching and community hospitals may serve as a baseline to which other pediatric facilities can compare their experience.

Key Words: adverse drug reaction • hospital admission

Submitted on July 20, 1987




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