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Impact of Antibiotic Exposure on Pediatric Drug Eruption: A Nationwide Cohort Study in Korea

Soo Min Jeon1, Junwoo Jo2, Juhee Ryu3

  • 1Jeju Research Institute of Pharmaceutical Sciences, College of Pharmacy, Jeju National University, Jeju, Korea.

Allergy, Asthma & Immunology Research
|December 2, 2025
PubMed

Insights

Antibiotic exposure significantly increases the risk of drug eruptions in children. Multiple antibiotic use further elevates this risk, highlighting the need for cautious prescribing in pediatric populations.

Area of Science:

  • Pediatric Dermatology
  • Pharmacovigilance
  • Adverse Drug Reactions

Background:

  • Antibiotic-related drug eruptions are common in children but their incidence and risk factors are not well-defined.
  • Understanding these factors is crucial for pediatric patient safety.

Purpose of the Study:

  • To investigate the incidence of drug eruptions in pediatric populations.
  • To determine the association between antibiotic exposure and drug eruptions.
  • To identify potential risk factors for antibiotic-related drug eruptions in children.

Main Methods:

  • Retrospective nationwide cohort study using the Health Insurance Review and Assessment Service-Pediatric Patient Sample database (2009-2019).
  • Involved 6,699,010 pediatric patients, analyzing drug eruptions via ICD-10 codes L27.0 and L27.1.
  • Compared incidence rates between antibiotic-exposed and unexposed groups.

Main Results:

  • Overall drug eruption incidence was 10.84 per 10,000 person-years.
  • Antibiotic-exposed group had higher incidence (14.59) vs. unexposed (4.89).
  • Antibiotic exposure increased risk (aHR, 2.86; 95% CI, 2.27-3.60), with higher risk for multiple antibiotic use.

Conclusions:

  • Antibiotic exposure is a significant risk factor for drug eruptions in pediatric patients.
  • The risk is amplified with the use of multiple antibiotics.
  • Judicious antibiotic prescribing, especially combination therapy, is recommended for children.
Abstract

Keywords:
Anti-bacterial agentsadverse drug reactioncohort studiesdrug eruptionsexposureincidencepediatricsrisk

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