Descriptive study of adverse drug reactions in a tertiary care pediatric hospital in México from 2014 to 2017

PLoS One. 2020 Mar 24;15(3):e0230576. doi: 10.1371/journal.pone.0230576. eCollection 2020.

Abstract

Introduction: In Pediatrics, adverse drug reactions (ADRs) affect morbidity and mortality. In Mexico, the characteristics of ADRs and suspect drugs have not been described in hospitalized children.

Objective: To estimate the frequency of ADRs and describe them, as well as suspect drugs, in a tertiary care pediatric hospital in Mexico.

Methods: A total of 1,649 Hospital Infantil de Mexico Federico Gómez ADR reports were analyzed. Completeness of the information was assessed, and ADRs severity and seriousness were assigned based on NOM-220-SSA1-2012, with causality being established according to the Naranjo algorithm. ADRs were classified with WHO Adverse Drug Reaction Terminology (WHO-ART). The drugs involved in ADRs were categorized according to the Anatomical Therapeutic Chemical (ATC) classification. Descriptive analysis was performed using the SPSS 20 statistical package.

Results: Of all the reports, 5.8% lacked sufficient information for the analysis (grade 0). ADRs frequency ranged from 2.12% to 8.07%. ADRs occurred most commonly in children (56.9%), in the female gender (52%), in subjects with normal BMI Z-score (46.6%) and malnutrition (35.3%), diagnosed with neoplasms (72.2%) and in the Emergency Department (70.0%). ADRs were severe in 14.4% of cases, in 81.0% they were serious and 2.1% were classified as definite. Most common serious ADR was febrile neutropenia (44.5%). The 0.7% of patients recovering with sequelae; 1.1% died (with the medication being associated) and 70.3% were admitted to the hospital as a result of an ADR. Antineoplastic and immunomodulating agents were more commonly associated with serious ADRs.

Conclusion: ADRs affected morbidity and mortality, which is why strengthening pharmacovigilance programs in Mexican pediatric hospitals is necessary.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury / etiology
  • Adolescent
  • Adult
  • Adverse Drug Reaction Reporting Systems
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Child
  • Child, Preschool
  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • Drug-Related Side Effects and Adverse Reactions / mortality
  • Drug-Related Side Effects and Adverse Reactions / pathology*
  • Female
  • Hospitals, Pediatric
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mexico / epidemiology
  • Neoplasms / diagnosis
  • Neoplasms / drug therapy
  • Severity of Illness Index
  • Sex Factors
  • Tertiary Healthcare
  • Young Adult

Substances

  • Antineoplastic Agents

Grants and funding

OMR received “Federal Funding” for this work (Grant Number: HIM 2018-003 SSA 1470). The funding entity had no participation in the study design, data collection and analysis, decision to publish, or preparation of the manuscript