Adverse Reactions to Antibiotics Cause Thousands of ER Visits

Adverse events from antibiotics cause an estimated 142,000 emergency room (ER) visits per year in the United States alone, according to a new study.

Researchers from the U.S. Centers for Disease Control and Prevention (CDC; Atlanta, GA, USA) examined data from the U.S. National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance (NEISS-CADES) project--a sample of 63 hospitals in the United States and its territories--to estimate and compare the numbers and rates of adverse events from systemic antibiotics by class, drug, and event type. Based on 6,614 cases, the researchers estimated that 142,505 visits annually were made to ERs for drug-related adverse events attributable to systemic antibiotics.

The researchers found that 50% of the ER visits were for reactions to penicillin derivatives, and the other 50% were from reactions to other antibiotics used to treat a wide variety of bacterial infections. Compared with all other antibiotic classes, sulfonamides were associated with a significantly higher rate of moderate-to-severe allergic reactions, and sulfonamides and fluoroquinolones were associated with a significantly higher rate of neurologic or psychiatric disturbances. Almost 80% of all antibiotic adverse events in the study were allergic reactions, ranging from rash to anaphylaxis, and the remaining 20% were caused by medication errors and overdoses. The researchers found that only 6% of the patients who had adverse events required hospitalization. Children less than one-year-old were found to have the highest rate of adverse drug events. The study was published in the September 15, 2008, issue of the journal Clinical Infectious Diseases.

"For conditions in which antibiotics have questionable benefit, such as many mild upper respiratory tract infections, weighing the benefits of antibiotics with the risks of a serious adverse event will be especially important,” said study author Daniel Budnitz, M.D., of the U.S. National Center for Detection, Preparedness, and Control of Infectious Diseases at the CDC. "Because antibiotics are frequently used, both appropriately and inappropriately, if doctors would reduce the number of antibiotics they prescribe to their patients by even a small percentage, we could significantly reduce the number of emergency visits for antibiotic adverse events. Physicians need to communicate to their patients that antibiotics are not harmless.”

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Centers for Disease Control and Prevention