PMID- 29679226 OWN - NLM STAT- MEDLINE DCOM- 20191118 LR - 20200306 IS - 1525-1497 (Electronic) IS - 0884-8734 (Print) IS - 0884-8734 (Linking) VI - 33 IP - 7 DP - 2018 Jul TI - National Estimates of Emergency Department Visits for Antibiotic Adverse Events Among Adults-United States, 2011-2015. PG - 1060-1068 LID - 10.1007/s11606-018-4430-x [doi] AB - BACKGROUND: Detailed, nationally representative data describing high-risk populations and circumstances involved in antibiotic adverse events (AEs) can inform approaches to prevention. OBJECTIVE: Describe US burden, rates, and characteristics of emergency department (ED) visits by adults for antibiotic AEs. DESIGN: Nationally representative, public health surveillance of adverse drug events (National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance [NEISS-CADES]) and a nationally projected database of dispensed prescriptions (QuintilesIMS), 2011-2015. PATIENTS: Antibiotic-treated adults (>/= 20 years) seeking ED care. MAIN MEASURES: Estimated annual numbers and rates of ED visits for antibiotic AEs among outpatients treated with systemically administered antibiotics. KEY RESULTS: Based on 10,225 cases, US adults aged >/= 20 years made an estimated 145,490 (95% confidence interval, 115,279-175,701) ED visits for antibiotic AEs each year in 2011-2015. Antibiotics were implicated in 13.7% (12.3-15.2%) of all estimated adult ED visits for adverse drug events. Most (56.6%; 54.8-58.4%) antibiotic AE visits involved adults aged < 50 years, and 71.8% (70.4-73.1%) involved females. Accounting for prescriptions dispensed from retail and long-term care pharmacies, adults aged 20-34 years had twice the estimated rate of ED visits for oral antibiotic AEs compared with those aged >/= 65 years (9.7 [7.6-11.8] versus 4.6 [3.6-5.7] visits per 10,000 dispensed prescriptions, respectively). Allergic reactions accounted for three quarters (74.3%; 70.0-78.6%) of estimated ED visits for antibiotic AEs. The three most frequently implicated antibiotic classes in ED visits for antibiotic AEs were oral sulfonamides (23.2%; 20.6-25.8%), penicillins (20.8%; 19.3-22.4%), and quinolones (15.7%; 14.2-17.1%). Per-prescription rates declined with increasing age group. CONCLUSIONS: Antibiotics are a common cause of ED visits by adults for adverse drug events and represent an important safety issue. Quantifying risks of AEs from specific antibiotics for specific patient populations, such as younger adults, provides additional information to help clinicians assess risks versus benefits when making the decision to prescribe or not prescribe an antibiotic. AE rates may also facilitate communication with patients about antibiotic risks. FAU - Geller, Andrew I AU - Geller AI AD - Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, Mailstop D-26, Atlanta, GA, 30333, USA. ageller@cdc.gov. FAU - Lovegrove, Maribeth C AU - Lovegrove MC AD - Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, Mailstop D-26, Atlanta, GA, 30333, USA. FAU - Shehab, Nadine AU - Shehab N AD - Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, Mailstop D-26, Atlanta, GA, 30333, USA. FAU - Hicks, Lauri A AU - Hicks LA AD - Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, Mailstop D-26, Atlanta, GA, 30333, USA. FAU - Sapiano, Mathew R P AU - Sapiano MRP AD - Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, Mailstop D-26, Atlanta, GA, 30333, USA. FAU - Budnitz, Daniel S AU - Budnitz DS AD - Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, Mailstop D-26, Atlanta, GA, 30333, USA. LA - eng PT - Journal Article PT - Research Support, U.S. Gov't, Non-P.H.S. DEP - 20180420 PL - United States TA - J Gen Intern Med JT - Journal of general internal medicine JID - 8605834 RN - 0 (Anti-Bacterial Agents) SB - IM CIN - J Gen Intern Med. 2018 Jul;33(7):1140. PMID: 29725822 MH - Adult MH - Adverse Drug Reaction Reporting Systems/*trends MH - Aged MH - Ambulatory Care/*trends MH - Anti-Bacterial Agents/*adverse effects MH - Drug-Related Side Effects and Adverse Reactions/diagnosis/*epidemiology/*therapy MH - Emergency Service, Hospital/*trends MH - Female MH - Humans MH - Male MH - Middle Aged MH - United States/epidemiology MH - Young Adult PMC - PMC6025673 OTO - NOTNLM OT - community health OT - evidence-based medicine OT - patient safety OT - pharmaceutical care OT - primary care COIS- CONFLICT OF INTEREST: The authors declare that they do not have a conflict of interest. DISCLAIMER: Federal government employees had a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. However, the findings in and conclusions of this study are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention. PRIOR PRESENTATIONS: None. EDAT- 2018/04/22 06:00 MHDA- 2019/11/19 06:00 PMCR- 2019/07/01 CRDT- 2018/04/22 06:00 PHST- 2017/09/11 00:00 [received] PHST- 2018/03/20 00:00 [accepted] PHST- 2018/02/07 00:00 [revised] PHST- 2018/04/22 06:00 [pubmed] PHST- 2019/11/19 06:00 [medline] PHST- 2018/04/22 06:00 [entrez] PHST- 2019/07/01 00:00 [pmc-release] AID - 10.1007/s11606-018-4430-x [pii] AID - 4430 [pii] AID - 10.1007/s11606-018-4430-x [doi] PST - ppublish SO - J Gen Intern Med. 2018 Jul;33(7):1060-1068. doi: 10.1007/s11606-018-4430-x. Epub 2018 Apr 20.