Association between medication and intestinal intussusception in children: a case-crossover study
Lourdes Vega García1, Virginia Fuentes-Leonarte, José María Tenías
1From the *Valencian School of Health Studies, Valencia; †Spanish Consortium for Research on Epidemiology and Public Health, Spain; ‡Center for Advanced Research in Public Health, Valencia; §Research Support Unit, Hospital General La Mancha Centro, Spain; and ∥Department of Pediatrics, Hospital La Fe, Valencia, Spain.
Insights
Recent medication use, particularly antibiotics within 2-7 days, is linked to intussusception in children under two. This finding highlights potential drug-related risks for pediatric intussusception.
Area of Science:
- Pediatric Gastroenterology
- Clinical Epidemiology
- Pharmacovigilance
Background:
- Intussusception is a common cause of bowel obstruction in young children.
- The role of antecedent factors, including medication use, requires further investigation.
Purpose of the Study:
- To evaluate the association between intussusception and recent medication intake in children.
- To identify specific drug classes or timing associated with increased risk.
Main Methods:
- A case-crossover study design was employed.
- Data from 95 pediatric intussusception cases in Valencia, Spain (2006-2009) were analyzed.
- Medication exposure was assessed for 2, 7, and 15 days prior to symptom onset, using pharmaceutical records.
Main Results:
- An increased odds ratio for intussusception was observed with medication use in the 2-15 days preceding symptom onset.
- The association was strongest for medication use within 2 days prior to symptom onset (OR, 2.26).
- Antibiotic administration within 2 days showed a significant association (OR, 8.00), particularly in children under two years.
Conclusions:
- Intussusception is more prevalent in boys under two years old.
- A significant association exists between intussusception and medication administration 2-7 days prior to symptom onset in children under two.
- Recent antibiotic use is a potential risk factor for pediatric intussusception.
Objectives:
This study aimed to assess the association between the appearance of intussusception in children and medication intake in the immediately preceding period (2-15 days).
Methods:
A case-crossover design was used. We selected cases of children admitted with a diagnosis of intussusception (International Classification of Diseases, Ninth Revision, 860) to the major hospitals in the city of Valencia, Spain, from 2006 to 2009. We then estimated the association between the episode of intussusception and the intake of prescription medication during the preceding 2, 7, and 15 days (case period) and for the same time window 1, 2, 3, and 4 months prior (control period). Data on previous drug administration were obtained from the Pharmaceutical Service Manager System.
Results:
A total of 95 cases (65.3% boys and 34.7% girls) were selected; 76.6% were younger than the age of 2 years. The association between intussusception and prior drug use varied depending on the exposure window: 15-day odds ratio (OR), 1.45 (95% confidence interval [95% CI], 0.86-2.43); 7-day OR, 1.46 (95% CI, 0.80-2.67); and 2-day OR, 2.26 (95% CI, 1.10-4.64). These associations were greater for children aged younger than 2 years and were usually due to the recent administration (preceding 2 days) of antibiotics (OR, 8.00; 95% CI, 1.47-43.7).
Conclusions:
Intussusception was more common among boys aged younger than 2 years. A positive and significant association was observed when drugs were administered 2 to 7 days before the onset of symptoms in children younger than the age of 2 years.
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