Association of Adverse Events With Antibiotic Use in Hospitalized Patients

Estimates of the incidence of overall antibiotic-associated adverse drug events (ADEs) in hospitalized patients are generally unavailable. To describe the incidence of antibiotic-associated ADEs for adult inpatients receiving systemic antibiotic therapy. Retrospective cohort of adult inpatients admi...

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Vydáno v:JAMA internal medicine Ročník 177; číslo 9; s. 1308
Hlavní autoři: Tamma, Pranita D, Avdic, Edina, Li, David X, Dzintars, Kathryn, Cosgrove, Sara E
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.09.2017
Témata:
Adverse Drug Reaction Reporting Systems - statistics & numerical data
Aged
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - adverse effects
Drug Administration Routes
Drug-Related Side Effects and Adverse Reactions - classification
Drug-Related Side Effects and Adverse Reactions - epidemiology
Drug-Related Side Effects and Adverse Reactions - etiology
Female
Hospitalization - statistics & numerical data
Humans
Incidence
Inpatients - statistics & numerical data
Male
Medical Overuse - prevention & control
Middle Aged
Needs Assessment
Patients' Rooms - statistics & numerical data
Practice Patterns, Physicians' - standards
United States - epidemiology
ISSN:2168-6114, 2168-6114
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Shrnutí:Estimates of the incidence of overall antibiotic-associated adverse drug events (ADEs) in hospitalized patients are generally unavailable. To describe the incidence of antibiotic-associated ADEs for adult inpatients receiving systemic antibiotic therapy. Retrospective cohort of adult inpatients admitted to general medicine wards at an academic medical center. At least 24 hours of any parenteral or oral antibiotic therapy. Medical records of 1488 patients were examined for 30 days after antibiotic initiation for the development of the following antibiotic-associated ADEs: gastrointestinal, dermatologic, musculoskeletal, hematologic, hepatobiliary, renal, cardiac, and neurologic; and 90 days for the development of Clostridium difficile infection or incident multidrug-resistant organism infection, based on adjudication by 2 infectious diseases trained clinicians. In 1488 patients, the median age was 59 years (interquartile range, 49-69 years), and 758 (51%) participants were female. A total of 298 (20%) patients experienced at least 1 antibiotic-associated ADE. Furthermore, 56 (20%) non-clinically indicated antibiotic regimens were associated with an ADE, including 7 cases of C difficile infection. Every additional 10 days of antibiotic therapy conferred a 3% increased risk of an ADE. The most common ADEs were gastrointestinal, renal, and hematologic abnormalities, accounting for 78 (42%), 45 (24%), and 28 (15%) 30-day ADEs, respectively. Notable differences were identified between the incidence of ADEs associated with specific antibiotics. Although antibiotics may play a critical role when used appropriately, our findings underscore the importance of judicious antibiotic prescribing to reduce the harm that can result from antibiotic-associated ADEs.
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ISSN:2168-6114
2168-6114
DOI:10.1001/jamainternmed.2017.1938