Adverse reactions to antibiotics send 70,000 kids to ERs each year

ATLANTA — Antibiotics are a double-edged sword. While they are great at treating bacterial infections, their overuse has led to the development of antibiotic-resistant bacteria. But there is also another danger, a new study warns: Antibiotic-related allergic reactions and side effects, which send nearly 70,000 U.S. children to an emergency room each year.

Researchers with the Centers for Disease Control and Prevention (CDC) sought to gauge the prevalence of hospitalizations among children stemming from reactions to antibiotic medications. They say the eye-popping statistics demonstrate just how careful parents and guardians should be when it comes to using antibiotics.

“For parents and other caregivers of children, these findings are a reminder that while antibiotics save lives when used appropriately, antibiotics also can harm children and should only be used when needed,” says lead author Maribeth C. Lovegrove, with the CDC’s Division of Healthcare Quality Promotion, in a statement. “For health care providers, these findings are a reminder that adverse effects from antibiotics are common and can be clinically significant and consequential for pediatric patients.”

Researchers analyzed estimates from 2011 to 2015 of nationwide outpatient antibiotic prescriptions and antibiotic-related ER visits in children 19 years of age and under. The vast majority of visits (86 percent) involved allergic reactions, such as rash, itching or severe swelling beneath the skin.

While adverse reactions differed across age groups and by type of antibiotic, children aged 2 and under faced the greatest risk of a bad reaction. Four in 10 emergency room visits due to antibiotic reactions involved children from this age group.

Amoxicillin was the most common culprit in antibiotic adverse events for children 9 years or younger. In children ages 10-19 years, sulfamethoxazole/trimethoprim was to blame.

Researchers caution that some information was not available for this study, such as which specific antibiotic prescriptions were unnecessary or unsuitable for the treatment plan. They believe the study numbers are almost inevitably low because only visits to hospital emergency rooms were included. It is not known how many adverse antibiotic events occurred in which either no health care was sought or the patient was seen in a doctor’s office or urgent care facility.

Parents of sick kids want a quick cure, and this has no doubt helped make antibiotics some of the most commonly prescribed drugs for children. Previous research has determined that perhaps a third or more prescriptions for antibiotics are not needed. But researchers say it is time to look beyond antibiotic resistance. Treatment decisions also need to take into account the possibility of adverse reactions.

“By considering available data on the immediate risks to individual patients, clinicians, and parents and caregivers, can better weigh the risks and benefits of antibiotic treatment,” says Lovegrove.

Study results were published August 23 in the Journal of the Pediatric Infectious Diseases Society.

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