Reported adverse drug events in infants and children under
2 years of age.
Moore TJ, Weiss SR, Kaplan S, Blaisdell CJ.
Center for Health Services Research and Policy, George Washington University
School of Public Health and Health Services, Washington, DC 20006, USA. tjm@gwu.edu
OBJECTIVE: To characterize risks to infants and young children from drugs and
biological products that were identified in spontaneous adverse event reports
submitted to the US Food and Drug Administration. METHODS: Of >500 000
MedWatch adverse event reports received by the Food and Drug Administration
from November 1997 through December 2000, we identified 7111 reports about
infants and children younger than age 2. The reports were analyzed for health
outcome (eg, death, hospitalization, congenital anomaly), principal suspect
drug, and whether the route of drug exposure was direct administration or
through the mother in the perinatal period. RESULTS: Drug therapy was
associated with an average of 243 reported deaths annually over the 38-month
study period, with 100 (41%) occurring during the first month of life and 204
(84%) during the first year. In 1432 (24%) reported adverse event cases of all
levels of severity, exposure to the drug was from the mother during pregnancy,
delivery, or lactation. Although 1902 different drugs, biological products,
and other chemicals were identified in the reports, only 17 drugs or
biological products were a suspect in 54% of all serious and fatal adverse
events in drugs administered directly. CONCLUSION: Adverse reactions to drug
therapy are a significant cause of death and injury in infants and children
under 2 years of age. Drugs administered to the mother in the perinatal period
constituted a major route of exposure to adverse drug advents. These results
underscore the need for additional drug testing in the youngest pediatric
patients and for carefully weighing the risks versus benefits of medication.
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