title: Could adverse reactions of antibiotic drugs in children be detected in a prescription database?
abstract: OBJECTIVE
  To explore the possibility to detect adverse drug reactions (ADRs) from a pharmacy prescription database by examining the use of proxy-drugs during the treatment.
  
  
  METHODS
  From a pharmacy prescription database we selected all children of 0-6 years old who started an antibiotic drug between 1999 and 2006. In the period of 5 days before till 12 days after the initiation of the antibiotic, we examined the number of prescriptions of 5 groups of proxy-drugs associated with adverse reactions: propulsives, skinmedication, antihistaminics, drugs against candidiasis and diarrhea. We did this also for cases where the children did not use any other drugs on the start day (t = 0) and the 5 days before, to focus on the use of proxy-drugs not related to the infection.
  
  
  RESULTS
  A total of 105,804 antibiotic courses were selected. The use of the proxy-drugs was the highest at the first day with no significant increase in the days thereafter. In case of no use of any other drugs from day -5 till day 0 a significant increase of antihistaminic use on day 7 and 8 and of skin medication use on day 7 was found.
  
  
  CONCLUSIONS
  Examining prescriptions of proxy drugs is not an optimal method to detect adverse reactions. An increase of antihistaminic use and skin medication use around day 7 in patients who had no other prescriptions 5 days before and on the first day of the course could be an indication for a skin reaction or allergy.
authors.affiliation: Department of Pharmacoepidemiology and Pharmacoeconomics, University of Groningen, Groningen, The Netherlands. josta.de.jong@rug.nl
authors.forename: Josta
authors.initials: J
authors.lastname: de Jong
authors.forename: Jens H J
authors.initials: JH
authors.lastname: Bos
authors.forename: Tjalling W
authors.initials: TW
authors.lastname: de Vries
authors.forename: Lolkje T W
authors.initials: LT
authors.lastname: de Jong-van den Berg
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003157:Community Pharmacy Services / Q000706:statistics & numerical data*; D016208:Databases, Factual / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D007223:Infant; D009426:Netherlands
chemical_list: D000900:Anti-Bacterial Agents