Study: Antibiotics Responsible for 20% of Adverse Drug Events

Jennifer Thew, RN, June 14, 2017

Healthcare providers should exercise caution when prescribing antibiotics as adverse drug reactions can extend hospital stays and increase emergency department visits.

Antibiotics can be an important part of a patient’s treatment plan, but healthcare providers should be mindful that the drugs do not come without risks, write authors of a new study published in JAMA Internal Medicine. After examining medical records of 1488 patients, researchers at The Johns Hopkins Hospital found that 20% of hospitalized patients who received at least 24 hours of antibiotic therapy developed antibiotic-associated adverse drug events. Additionally, 20% of adverse drug effects were attributable to antibiotics prescribed for conditions that did not warrant the use of antibiotics.

The study’s authors stress that healthcare providers need to be judicious when prescribing antibiotics to reduce the occurrence of adverse drug events.

 “Too often, clinicians prescribe antibiotics even if they have a low suspicion for a bacterial infection, thinking that even if antibiotics may not be necessary, they are probably not harmful,” says Pranita Tamma, MD, MHS, assistant professor of pediatrics and director of the Pediatric Antimicrobial Stewardship Program at The Johns Hopkins Hospital in a news release. “But that is not always the case. Antibiotics have the potential to cause real harm to patients. Each time we think to prescribe an antibiotic, we need to pause and ask ourselves, ‘Does this patient really need an antibiotic?’”

Adverse Drug Effects Prolong Hopsital Length of Stay

Between September 2013 to June 2014, researchers reviewed medical records of patients admitted to the general medicine services at The Johns Hopkins Hospital. Patients were followed for 30 days after hospital discharge to determine the likelihood of an adverse reaction to antibiotics and to identify how many adverse reactions could be prevented by eliminating unnecessary antibiotic use. They were observed for up to 90 days for the development of Clostridium difficile infection and for development of new multidrug-resistant infections.  

In addition to finding that 20% of patients experienced one or more antibiotic adverse effect, researchers also found that antibiotic side effects increased by 3% for each additional 10 days of antibiotic therapy. The most common side effects experienced were gastrointestinal, kidney, and blood abnormalities. A total of 4% and 6% of patients developed C. difficile infections and potential multidrug-resistant organism infections. No deaths were attributed to any antibiotic side effects in this study

The researchers say 24% of patients had prolonged hospital stays; 3% percent experienced additional hospital admissions; 9% required additional ED or clinic visits; and 61% needed additional diagnostic tests due to adverse drug effects.

Adverse drug reactions in general are a serious and costly problem. The CDC estimates that each year adverse drug events cause more than 1 million ED visits and 280,000 hospitalizations and contribute to an additional $3.5 billion in medical costs of annually. 

Jennifer Thew, RN

Jennifer Thew, RN is the senior nursing editor at HealthLeaders Media.

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