title: Adverse drug reactions causing admission to a paediatric hospital.
abstract: OBJECTIVE
  To obtain reliable information about the incidence of adverse drug reactions, and identify potential areas where intervention may reduce the burden of ill-health.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  A large tertiary children's hospital providing general and specialty care in the UK.
  
  
  METHODS
  All acute paediatric admissions over a one year period.
  
  
  METHODS
  Any medication taken in the two weeks prior to admission.
  
  
  METHODS
  Occurrence of adverse drug reaction.
  
  
  RESULTS
  240/8345 admissions in 178/6821 patients admitted acutely to a paediatric hospital were thought to be related to an adverse drug reaction, giving an estimated incidence of 2.9% (95% CI 2.5, 3.3), with the reaction directly causing, or contributing to the cause, of admission in 97.1% of cases. No deaths were attributable to an adverse drug reaction. 22.1% (95% CI 17%, 28%) of the reactions were either definitely or possibly avoidable. Prescriptions originating in the community accounted for 44/249 (17.7%) of adverse drug reactions, the remainder originating from hospital. 120/249 (48.2%) reactions resulted from treatment for malignancies. The drugs most commonly implicated in causing admissions were cytotoxic agents, corticosteroids, non-steroidal anti-inflammatory drugs, vaccines and immunosuppressants. The most common reactions were neutropenia, immunosuppression and thrombocytopenia.
  
  
  CONCLUSIONS
  Adverse drug reactions in children are an important public health problem. Most of those serious enough to require hospital admission are due to hospital-based prescribing, of which just over a fifth may be avoidable. Strategies to reduce the burden of ill-health from adverse drug reactions causing admission are needed.
authors.affiliation: Department of Women's and Children's Health, University of Liverpool, Liverpool, United Kingdom. ruairi.gallagher@nhs.net
authors.forename: Ruairi M
authors.initials: RM
authors.lastname: Gallagher
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Mason
authors.forename: Kim A
authors.initials: KA
authors.lastname: Bird
authors.forename: Jamie J
authors.initials: JJ
authors.lastname: Kirkham
authors.forename: Matthew
authors.initials: M
authors.lastname: Peak
authors.forename: Paula R
authors.initials: PR
authors.lastname: Williamson
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Nunn
authors.forename: Mark A
authors.initials: MA
authors.lastname: Turner
authors.forename: Munir
authors.initials: M
authors.lastname: Pirmohamed
authors.forename: Rosalind L
authors.initials: RL
authors.lastname: Smyth
mesh_terms: D002648:Child; D002675:Child, Preschool; D064420:Drug-Related Side Effects and Adverse Reactions; D006776:Hospitals, Pediatric; D006801:Humans; D010343:Patient Admission; D011446:Prospective Studies; D006113:United Kingdom