PMID- 33452808
OWN - NLM
STAT- MEDLINE
DCOM- 20210809
LR  - 20220117
IS  - 2048-7207 (Electronic)
IS  - 2048-7193 (Print)
IS  - 2048-7193 (Linking)
VI  - 10
IP  - 5
DP  - 2021 May 28
TI  - Antibiotic-Associated Adverse Events in Hospitalized Children.
PG  - 622-628
LID - 10.1093/jpids/piaa173 [doi]
AB  - BACKGROUND: Antibiotic-associated adverse events (AEs) in hospitalized children 
      have not been comprehensively characterized. METHODS: We conducted a 
      retrospective observational study of children hospitalized at The Johns Hopkins 
      Hospital receiving >/=24 hours of systemic antibiotics. Consensus regarding 
      antibiotic-associated AE definitions was established by 5 infectious diseases 
      specialists prior to data collection. Two physicians reviewed potential AEs and 
      determined whether they were more likely than not related to antibiotics after 
      comprehensive manual chart review. Inpatient and post-discharge AEs were 
      identified using the Epic Care Everywhere network. AEs evaluated from the 
      initiation of antibiotics until 30 days after antibiotic completion included 
      gastrointestinal, hematologic, hepatobiliary, renal, neurologic, dermatologic, 
      cardiac, myositis, vascular access device-related events, and systemic reactions. 
      Ninety-day AEs included Clostridioides difficile infections, multidrug-resistant 
      organism infections, and clinically significant candidal infections. The impact 
      of AEs was categorized as necessitating additional diagnostic testing, changes in 
      medications, unplanned medical encounters, prolonged or new hospitalizations, or 
      death. RESULTS: Among 400 antibiotic courses, 21% were complicated by at least 
      one AE and 30% occurred post-discharge. Each additional day of antibiotics was 
      associated with a 7% increased odds of an AE. Of courses complicated by an AE, 
      66% required further intervention. Hematologic, gastrointestinal, and renal AEs 
      were the most common, accounting for 31%, 15%, and 11% of AEs, respectively. AEs 
      complicated 35%, 35%, 19%, and 18% of courses of piperacillin-tazobactam, 
      tobramycin, ceftazidime, and vancomycin, respectively. CONCLUSIONS: More than 1 
      in 5 courses of antibiotics administered to hospitalized children are complicated 
      by AEs. Clinicians should weigh the risk of harm against expected benefit when 
      prescribing antibiotics.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of The 
      Journal of the Pediatric Infectious Diseases Society. All rights reserved. For 
      permissions, please e-mail: journals.permissions@oup.com.
FAU - Same, Rebecca G
AU  - Same RG
AUID- ORCID: 0000-0003-0337-1168
AD  - Department of Pediatrics, The Johns Hopkins University School of Medicine, 
      Baltimore, Maryland, USA.
FAU - Hsu, Alice J
AU  - Hsu AJ
AD  - Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
FAU - Cosgrove, Sara E
AU  - Cosgrove SE
AUID- ORCID: 0000-0001-9458-4331
AD  - Department of Medicine, The Johns Hopkins University School of Medicine, 
      Baltimore, Maryland, USA.
FAU - Klein, Eili Y
AU  - Klein EY
AD  - Department of Emergency Medicine, The Johns Hopkins University School of 
      Medicine, Baltimore, Maryland, USA.
FAU - Amoah, Joe
AU  - Amoah J
AD  - Department of Pediatrics, The Johns Hopkins University School of Medicine, 
      Baltimore, Maryland, USA.
FAU - Hersh, Adam L
AU  - Hersh AL
AD  - Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.
FAU - Kronman, Matthew P
AU  - Kronman MP
AD  - Department of Pediatrics, University of Washington, Seattle, Washington, USA.
FAU - Tamma, Pranita D
AU  - Tamma PD
AUID- ORCID: 0000-0002-4143-6324
AD  - Department of Pediatrics, The Johns Hopkins University School of Medicine, 
      Baltimore, Maryland, USA.
LA  - eng
GR  - T32 AI052071/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - J Pediatric Infect Dis Soc
JT  - Journal of the Pediatric Infectious Diseases Society
JID - 101586049
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Aftercare
MH  - *Anti-Bacterial Agents/adverse effects/therapeutic use
MH  - Child
MH  - *Child, Hospitalized
MH  - Humans
MH  - Patient Discharge
PMC - PMC8162628
OTO - NOTNLM
OT  - adverse events
OT  - antibiotics
OT  - pediatrics
EDAT- 2021/01/17 06:00
MHDA- 2021/08/10 06:00
PMCR- 2022/01/16
CRDT- 2021/01/16 08:33
PHST- 2020/08/31 00:00 [received]
PHST- 2020/12/23 00:00 [accepted]
PHST- 2021/01/17 06:00 [pubmed]
PHST- 2021/08/10 06:00 [medline]
PHST- 2021/01/16 08:33 [entrez]
PHST- 2022/01/16 00:00 [pmc-release]
AID - 6102462 [pii]
AID - piaa173 [pii]
AID - 10.1093/jpids/piaa173 [doi]
PST - ppublish
SO  - J Pediatric Infect Dis Soc. 2021 May 28;10(5):622-628. doi: 
      10.1093/jpids/piaa173.