PMID- 26407410
OWN - NLM
STAT- MEDLINE
DCOM- 20170605
LR  - 20220316
IS  - 2048-7207 (Electronic)
IS  - 2048-7193 (Print)
IS  - 2048-7193 (Linking)
VI  - 4
IP  - 2
DP  - 2015 Jun
TI  - Adverse Events in Pediatric Patients Receiving Long-Term Outpatient 
      Antimicrobials.
PG  - 119-25
LID - 10.1093/jpids/piu037 [doi]
AB  - BACKGROUND: Although long treatment courses of outpatient antimicrobials are 
      often used in pediatric patients, few data exist regarding the frequency of 
      adverse events (AEs) associated with these medications. METHODS: We performed a 
      retrospective cohort study of all patients seen in the Infectious Diseases clinic 
      at a tertiary referral children's hospital from August 1, 2009 to August 1, 2011. 
      We included patients who received >/=14 days of oral or intravenous antibiotic, 
      antiviral, or antifungal medications. Patients receiving only prophylactic 
      medications or human immunodeficiency virus treatment were excluded. RESULTS: 
      Three hundred thirty-five subjects met inclusion criteria, with a median age of 
      7.4 years at start of therapy. The cohort was predominantly male (60%), white 
      (54%), and previously healthy (59%). A majority (88.4%) of subjects were treated 
      for bacterial infections. beta-Lactam agents were the most commonly used 
      antimicrobial class (210 subjects; 62.7%), followed by clindamycin (86; 25.7%), 
      rifampin (76; 22.7%), and vancomycin (62; 18.5%). Overall, 107 (31.9%) subjects 
      experienced 151 distinct AEs. The most common individual AE noted was diarrhea 
      (44; 29.1% of all AEs). Serious AEs developed in 42 (12.5%) subjects, including 
      allergic reactions (15; 11.3% of all AEs), venous catheter-related complications 
      (14; 13.0% of those with catheters), neutropenia (9; 3.0%), renal insufficiency 
      (7; 2.5%), and hepatotoxicity (3; 1.1%). Rates of AEs were similar between those 
      on oral and intravenous antimicrobials. CONCLUSIONS: In our study population, 
      patients on prolonged oral or intravenous outpatient antimicrobials experienced 
      AEs frequently. These findings support the need for close monitoring of pediatric 
      patients on prolonged antimicrobial therapy and vigilance for unwanted effects of 
      these medications.
CI  - (c) The Author 2014. Published by Oxford University Press on behalf of the 
      Pediatric Infectious Diseases Society. All rights reserved. For Permissions, 
      please e-mail: journals.permissions@oup.com.
FAU - Olson, Scott C
AU  - Olson SC
AD  - Department of Pediatrics Division of Infectious Diseases, University of 
      Washington, Seattle.
FAU - Smith, Sherilyn
AU  - Smith S
AD  - Department of Pediatrics Division of Infectious Diseases, University of 
      Washington, Seattle Center for Clinical and Translational Research.
FAU - Weissman, Scott J
AU  - Weissman SJ
AD  - Department of Pediatrics Division of Infectious Diseases, University of 
      Washington, Seattle Center for Global Infectious Disease Research, Seattle 
      Children's Hospital Research Institute, Washington.
FAU - Kronman, Matthew P
AU  - Kronman MP
AD  - Department of Pediatrics Division of Infectious Diseases, University of 
      Washington, Seattle Center for Clinical and Translational Research.
LA  - eng
GR  - T32 HD007233/HD/NICHD NIH HHS/United States
GR  - 5T32HD007233/HD/NICHD NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20140430
PL  - England
TA  - J Pediatric Infect Dis Soc
JT  - Journal of the Pediatric Infectious Diseases Society
JID - 101586049
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Antifungal Agents)
RN  - 0 (Antiviral Agents)
SB  - IM
MH  - Abdominal Pain/chemically induced
MH  - Administration, Intravenous/adverse effects/statistics & numerical data
MH  - Administration, Oral
MH  - Adolescent
MH  - Ambulatory Care/*statistics & numerical data
MH  - Anti-Bacterial Agents/administration & dosage/*adverse effects
MH  - Antifungal Agents/administration & dosage/*adverse effects
MH  - Antiviral Agents/administration & dosage/*adverse effects
MH  - Catheters/adverse effects
MH  - Chemical and Drug Induced Liver Injury
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Diarrhea/chemically induced
MH  - Drug Hypersensitivity/etiology
MH  - Female
MH  - Humans
MH  - Infections/*complications/*drug therapy
MH  - Male
MH  - Nausea/chemically induced
MH  - Neutropenia/chemically induced
MH  - Renal Insufficiency/chemically induced
MH  - Retrospective Studies
MH  - Tertiary Care Centers/statistics & numerical data
MH  - Vomiting/chemically induced
PMC - PMC4608493
OTO - NOTNLM
OT  - adverse events
OT  - antimicrobial stewardship
OT  - antimicrobials
OT  - outpatient
OT  - pediatrics
EDAT- 2015/09/26 06:00
MHDA- 2017/06/06 06:00
PMCR- 2016/06/01
CRDT- 2015/09/26 06:00
PHST- 2014/01/13 00:00 [received]
PHST- 2014/04/05 00:00 [accepted]
PHST- 2015/09/26 06:00 [entrez]
PHST- 2015/09/26 06:00 [pubmed]
PHST- 2017/06/06 06:00 [medline]
PHST- 2016/06/01 00:00 [pmc-release]
AID - piu037 [pii]
AID - 10.1093/jpids/piu037 [doi]
PST - ppublish
SO  - J Pediatric Infect Dis Soc. 2015 Jun;4(2):119-25. doi: 10.1093/jpids/piu037. Epub 
      2014 Apr 30.