Incidence and Risk Factors of Adverse Drug Reactions Related with Antimicrobials: A Single Center Study

Abstract

Objective: Domestic antimicrobial usage is the third-highest among the OECD countries, and the incidence of adverse drug reactions (ADRs) due to the use of antimicrobials is reported to be higher than other drug groups. Considering the high antimicrobial usage in Korea, this study aimed to investigate the incidence and risk factors of major antimicrobial-related ADRs in Korean medical environment. Methods: The data were retrospectively collected among 998 randomly selected hospitalized patients, who were prescribed one or more antimicrobials from January 1, 2017 to March 31, 2017. We defined the signals that reflect allergic reaction, hematologic toxicity (neutropenia, thrombocytopenia), nephrotoxicity, hepatotoxicity, antimicrobial-induced diarrhea, and Clostridium difficile-associated diarrhea (CDAD). Patients with abnormal signals were assessed for causality by retrospective review of the medical records and risk factors were analyzed. Results: In 998 patients, 118 (11.8%) experienced at least one antimicrobial-related ADRs. The most common type of ADRs was CDAD (3.7%), followed by thrombocytopenia (3.2%), nephrotoxicity (3.1%), hepatotoxicity (2.1%), antimicrobial-induced diarrhea (1.5%) and neutropenia (1.5%). The risk factors for antimicrobial related ADRs were age over 65, renal disease, diabetes, cancer, duration of hospitalization over 14 days, average duration of antimicrobial uses over 14 days, and intensive care unit admission. Conclusion: By investigating the incidence of antimicrobial-related ADRs in single institute, we could identify the risk factors of antimicrobial-related ADRs. When antimicrobials are used in the patients with identified risk factors, careful attention should be paid to prevent antimicrobial-related ADRs.