Frontiers in pharmacology, cilt.12, ss.786182, 2021 (SCI-Expanded)
Drug safety in paediatric patients is a serious public health concern around the world. The
paediatric patients are more prone to adverse drug reactions (ADRs) than adults.
Moreover, there is a scarcity of information about ADRs in paediatric patients. This
study was conducted to determine the frequency, causality, severity, preventability of
paediatric patients’ ADRs reported in a tertiary care hospital in Adana, Turkey. A
retrospective study was conducted on all spontaneously reported ADRs between
January 01, 2020, to July 30, 2021, in paediatric patients. The ADRs reports were
evaluated in terms of gender, age, ADR characteristics, suspected drugs and reporting
source. All included ADRs reports were characterized according to the Naranjo Algorithm/
World Health Organization (WHO) causality scales, Hartwig/Siegel and Common
Terminology Criteria for Adverse Events (CTCAE) severity scales, the modified
Schoumock and Thornton preventability scale and hospital pharmacovigilance center
criteria for seriousness. Therapeutic groups were also coded using the WHO-Anatomical
Therapeutic and Chemical (ATC) classification. During the study period, 8,912 paediatric
patients who were admitted had 16 ADRs with 1.7 ADRs/1,000 admissions. The majority
of ADRs were found in infants (31.2%) and children (56.2%) as compared to adolescents
(12.5%). ADRs were observed more in females (81.2%) than males. Skin (62.5%) was the
most affected organ due to the ADRs, and maculopapular rash and erythema multiforme
were the most commonly reported symptoms. Most ADRs were probable/likely (93.7%),
severe (50%), preventable or probably preventable (43.7%) and serious (37.5%).
Antibiotics (93.7%) were found to be the most common cause of ADRs in paediatric
patients. The majority of ADRs were associated with vancomycin (68.7%). Most of the
ADRs were reported by a medical doctor in this study. This small sample size study
highlights significant problems of ADRs in paediatric patients, mainly caused by antibiotics
and with a majority of ADRs manifest as skin reactions. Furthermore, a high proportion of
the identified ADRs were found to be preventable. More focused efforts are needed at the
national level to avoid preventable ADRs in hospitals. Monitoring and management of
ADRs and future studies would be beneficial for better patient care and safety.
Keywords: adverse drug reactions, children, paediatric, antibiotics, patient safety, Turkey