Pediatria pre prax 1/2012

Adverse drug reactions specific to childhood

Good knowledge of adverse drug reactions (ADRs) is crucial for safe use of medication. ADRs are a common clinical problem in both pediatric and adult medicine that can lead to significant morbidity. More than 9 % of hospitalized children suffer some adverse reactions to therapy and up to 4 % of all their hospital admissions are caused by ADRs. The toxicity of many medicines in children is different to that seen in adults. Indeed, there are some groups of pediatric patients, such as neonates, in whom drug toxicity appears to be relatively common. About 70 % of drugs prescribed to the pediatric population are prescribed off-label. The risk of adverse drug reactions with such prescribing is 3,6-fold higher in the hospital setting and 2-fold higher in the outpatient setting compared to on-label prescribing. Most of the ADRs in children are similar to ADRs in adults. In this paper, ADRs specific for the pediatric population are discussed: Reye’s syndrome, Gray baby syndrome, quinolone arthropathy, tooth discoloration, growth disorders, psychiatric disorders and others.

Keywords: children, adverse drug reactions, Reye’s syndrome, chloramphenicol, grey syndrome, quinolones, tetracyclines, growth disorders, psychiatric disorders, acute agitation.