儿童药物不良反应的因果关系,严重程度和可避免性:一篇11年的回顾
Duaa Gaafar1,2,3, Noel Cranswick1,2,3, Renee Dimond4
1Departments of General Medicine, Infectious Diseases, and Children's Cancer Centre, Royal Children's Hospital, Parkville, Victoria, Australia.
British journal of clinical pharmacology
|November 25, 2025
概括
大约15%的儿科药物不良反应 (ADR) 可能是可以避免的. 这凸显了需要更好的ADR文档,药物监测和临床医师教育,以提高患者安全.
科学领域:
- 儿科药理学 儿科药理学
- 药物安全和药物监督是药物安全和药物监督的重要组成部分.
- 医院医药 医院医药 医院医药
背景情况:
- 药物不良反应 (ADR) 是儿童入院的重要原因之一.
- 这些反应有助于增加医疗保健利用率和成本.
- 了解儿童群体ADR的特征对于预防至关重要.
研究的目的:
- 评估住院儿童中ADRs的因果关系,严重程度和可避免性.
- 确定与儿科ADR相关的常见药物类别和反应类型.
- 为了确定可能被预防的副作用的比例.
主要方法:
- 在11年内对599名儿童 (0-18岁) 进行了回顾性队列研究.
- 排除了故意滥用药物或过量服用的情况.
- 评估因果关系 (纳兰乔标准),严重程度 (哈特维格尺度) 和可避免性 (修改的舒莫克和桑顿尺度).
- 不良反应的分类为A型 (剂量相关) 和B型 (特异性).
主要成果:
- 大多数ADR (74%) 是轻微的;15%是可能可以避免的.
- 抗微生物药物 (46%) 和止痛药 (9%) 是最常见的.
- 比A型 (剂量相关) 反应 (44%) 更常见的是B型 (异常) 反应 (56%).
- 可避免的不良反应是由于不考虑过敏,不正确的剂量,药物相互作用或缺乏预防措施造成的.
结论:
- 六分之一的儿科副作用是可以避免的,这表明有很大的改善空间.
- 完善的ADR文档,强大的药物监测系统和有针对性的临床医生教育是必不可少的.
- 实施预防策略可以减少住院儿童的副作用负担.
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