Survey of adverse drug reactions on a pediatric ward: a strategy for early and detailed detection

Pediatrics. 2002 Aug;110(2 Pt 1):254-7. doi: 10.1542/peds.110.2.254.

Abstract

Objective: Adverse drug reactions (ADRs) occur frequently in children. However, the exact incidence of ADRs is unknown. Therefore, we studied ADRs in 1 ward and assessed whether a general approach, eg, by a computerized monitoring system, to detect ADRs in children is feasible and likely to yield a higher rate of early detected ADRs. The aim was to assess the usefulness of a computerized monitoring system before implementing costly adaptations.

Methods: An 8-month prospective study was conducted at a 10-bed pediatric isolation ward of the University Hospital. Charts were reviewed once weekly by a pharmacoepidemiological team. Clinical signs as well as laboratory changes were documented and assessed. Algorithms were used to assess the probability and severity of each detected event.

Results: All 214 patients admitted were enrolled in the study. A total of 68 ADRs were detected in 46 of 214 patients by the pharmacoepidemiological team. Thirty-four ADRs (50%) were detected by the staff physician, and 27 (40%) were detected primarily by analyzing laboratory parameters. Antibiotics-associated ADRs (50%) predominated, followed by glucocorticoids (16%), tuberculostatic (4%), and immunosuppressive agents (4%). In 5 cases, an ADR was responsible for the prolongation of hospital stay, and in 4 children, the ADR was responsible for hospitalization.

Conclusions: The detection rate of ADRs would almost be doubled by a computerized monitoring system analyzing laboratory data. Implementation of a computer monitor system that automatically generates laboratory signals may help to identify ADRs in children, and to reduce morbidity and hospital stay, as well as costs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adverse Drug Reaction Reporting Systems*
  • Algorithms
  • Child
  • Child, Preschool
  • Communicable Diseases / drug therapy
  • Data Collection
  • Drug-Related Side Effects and Adverse Reactions*
  • Hospital Bed Capacity, under 100
  • Hospital Units / statistics & numerical data*
  • Hospitals, University / statistics & numerical data
  • Humans
  • Infant
  • Patient Isolation
  • Pediatrics / statistics & numerical data*
  • Probability
  • Prospective Studies