Adverse Drug Reactions in Hospitalised Children in Germany Are Decreasing Results of a Nine Year Cohort-Based Comparison 英文参考文献.docVIP

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Adverse Drug Reactions in Hospitalised Children in Germany Are Decreasing Results of a Nine Year Cohort-Based Comparison 英文参考文献.doc

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Adverse Drug Reactions in Hospitalised Children in Germany Are Decreasing Results of a Nine Year Cohort-Based Comparison 英文参考文献

AdverseDrugReactionsinHospitalisedChildrenin GermanyAreDecreasing:ResultsofaNineYearCohort- BasedComparison Ann-KathrinOehme1,AsiaN.Rashed2,BarbaraHefele3,IanC.K.Wong2,WolfgangRascher1, AntjeNeubert2,4 * 1Department of Paediatric and Adolescents Medicine, Friedrich-Alexander-University Erlangen/Nuremberg, Erlangen, Germany, 2Centre for Paediatric Pharmacy Research,UCLSchoolofPharmacy,London,UnitedKingdom,3DepartmentofChildrenandAdolescentsMedicineFriedrich-Alexander-UniversityErlangen/Nuremberg, Erlangen,Germany,4PaediatricClinicalStudyCenter,DepartmentofPaediatricandAdolescentsMedicineFriedrich-Alexander-UniversityErlangen/Nuremberg,Erlangen, Germany Abstract Background:Inrecentyears,effortshavebeenmadetoimprovepaediatricdrugtherapy.Theaimofthisresearchwasto investigateanychangesregardingthefrequencyandnatureofadversedrugreactions(ADRs)inhospitalizedchildrenin onepaediatricgeneralmedicalwardovera9-yearperiod. Methodology:TwoprospectiveobservationalcohortstudieswereconductedatalargeUniversityhospitalinGermanyin 1999and2008,respectively.Childrenaged0–18yearsadmittedtothestudywardduringthestudyperiodswereincluded. ADRswereidentifiedusingintensivechartreview.Uni-andmultivariableregressionhasbeenusedfordataanalysis. Results:Atotalof520patients(574admissions)wereincluded[1999:n=144(167);2008:n=376(407)].Patientsreceiveda totalof2053drugs[median3,interquartilerange(IQR)2–5].19%ofpatientsdidnotreceiveanymedication.Medianlength ofstaywas4days(IQR3–7;range1–190days)withasignificantlylongerlengthofstayin1999.TheoverallADRincidence was13.1%(95%CI,9.8–16.3)varyingsignificantlybetweenthetwostudycohorts[1999:21.9%,95%CI,14.7–29.0;2008: 9.2%, 95% CI, 5.9–12.5 (p,0.001)]. Antibacterials and corticosteroids for systemic use caused most of the ADRs in both cohorts(1999;2008).Exposuretosystemicantibacterialsdecreasedfrom62.9%to43.5%whereasexposuretoanalgesics andanti-inflammatorydrugsincreasedfrom17.4%to45.2%,respectively.Theuseofhighriskdrugsdecreasedfrom75%to 62.2%.In1999,45.7%and