Adverse Drug Reactions to Anti-infectives in Hospitalized Children: A Multicenter Study in Brazil

J Pediatric Infect Dis Soc. 2023 Feb 27;12(2):76-82. doi: 10.1093/jpids/piac121.

Abstract

Introduction: Adverse drug reactions (ADRs) to anti-infectives affect especially hospitalized children and contribute to increased morbidity, mortality, length of stay, and costs in healthcare systems.

Objective: To assess ADRs associated with anti-infective use in Brazilian hospitalized children.

Methods: A prospective cohort study was conducted in 5 public hospitals over 6 months. Children aged 0-11 years and 11 months who were hospitalized for more than 48 h and prescribed anti-infectives for over 24 h were included.

Results: A total of 1020 patients met the inclusion criteria. Of these, 152 patients experienced 183 suspected ADRs. Most reactions were related to the gastrointestinal system (65.6%), followed by skin reactions (18.6%). Most reactions were classified as probable causality (58.5%), moderate severity (61.1%), and unavoidable (56.2%). Our findings showed that ADRs were associated with increased length of stay (P < .001), increased length of therapy (P < .015), increased days of therapy (P = .038), and increased number of anti-infectives prescribed per patient (P < .001).

Conclusion: Almost 15% of hospitalized children exposed to anti-infectives presented suspected ADRs. Their occurrence was classified as probable, of moderate severity, and unavoidable. ADRs were significantly influenced by the length of hospital stay and the number of anti-infectives prescribed per patient.

Keywords: adverse drug reaction; anti-infectives; hospital; paediatric; patient safety.

Publication types

  • Multicenter Study

MeSH terms

  • Adverse Drug Reaction Reporting Systems
  • Anti-Infective Agents*
  • Brazil
  • Child
  • Child, Hospitalized
  • Drug-Related Side Effects and Adverse Reactions*
  • Humans
  • Prospective Studies

Substances

  • Anti-Infective Agents