Table 3.
Emergency Department (ED) Visits for Adverse Drug Events (ADEs) from the Most Commonly Implicated Oral Antibiotics, By Patient Age, Children ≤19 Years, United States, 2011-2015a
| Most Commonly Implicated Antibiotic Drug Products for Each Age Group | Cases | Annual National Estimate | ||
|---|---|---|---|---|
| ED Visits for Antibiotic ADEs | NNHb | |||
| No. | No. | % (95% CI) | ||
| Patients Aged <1-2 Years (Annual Estimate=27,871) | ||||
| Amoxicillin | 1,977 | 18,835 | 67.6 (63.6 - 71.5) | 334 |
| Amoxicillin/Clavulanate | 275 | 2,357 | 8.5 (6.8 - 10.1) | 723 |
| Cefdinir | 228 | 2,117 | 7.6 (5.3 - 9.9) | 851 |
| Azithromycin | 102 | 1,418 | 5.1 (3.9 - 6.3) | 1,458 |
| Cephalexin | 74 | 1,000 | 3.6 (2.2 - 5.0) | 566 |
| Sulfamethoxazole/Trimethoprim | 87 | 821 c | 2.9 (1.4 - 4.5) | 836c |
| Patients Aged 3-4 Years (Annual Estimate=7,067) | ||||
| Amoxicillin | 430 | 3,852 | 54.5 (49.5 - 59.5) | 958 |
| Amoxicillin/Clavulanate | 71 | 707 | 10.0 (6.2 - 13.8) | 1,474 |
| Cefdinir | 63 | 562 | 7.9 (4.5 - 11.3) | 1,873 |
| Azithromycin | 44 | 544 | 7.7 (5.1 - 10.3) | 3,126 |
| Sulfamethoxazole/Trimethoprim | 46 | 486 | 6.9 (3.9 - 9.8) | 1,039 |
| Cephalexin | 29 | 264 | 3.7 (2.1 - 5.4) | 1,870 |
| Patients Aged 5-9 Years (Annual Estimate=11,931) | ||||
| Amoxicillin | 566 | 5,330 | 44.7 (39.9 - 49.5) | 1,331 |
| Sulfamethoxazole/Trimethoprim | 155 | 1,768 | 14.8 (10.6 - 19.1) | 539 |
| Azithromycin | 94 | 1,024 | 8.6 (6.1 - 11.0) | 3,364 |
| Amoxicillin/Clavulanate | 82 | 876 | 7.3 (5.1 - 9.6) | 2,075 |
| Cefdinir | 83 | 793 | 6.6 (4.3 - 9.0) | 2,033 |
| Cephalexin | 59 | 624 | 5.2 (3.5 - 7.0) | 1,929 |
| Penicillin | 26 | 371 | 3.1 (1.6 - 4.6) | 707 |
| Clindamycin | 35 | 335 | 2.8 (1.4 - 4.2) | 646 |
| Patients Aged 10-19 Years (Annual Estimate=21,249) | ||||
| Sulfamethoxazole/Trimethoprim | 384 | 5,167 | 24.3 (20.3 - 28.4) | 413 |
| Amoxicillin | 366 | 4,414 | 20.8 (18.3 - 23.3) | 1,469 |
| Azithromycin | 153 | 2,225 | 10.5 (8.0 - 13.0) | 2,529 |
| Cephalexin | 127 | 1,711 | 8.1 (5.9 - 10.2) | 1,326 |
| Amoxicillin/Clavulanate | 112 | 1,419 | 6.7 (5.3 - 8.1) | 1,720 |
| Clindamycin | 126 | 1,304 | 6.1 (4.9 - 7.4) | 509 |
| Doxycycline | 78 | 845 | 4.0 (2.5 - 5.4) | 2,344 |
| Ciprofloxacin | 52 | 773 | 3.6 (2.2 - 5.1) | 700 |
| Minocycline | 58 | 686 | 3.2 (2.1 - 4.3) | 2,628 |
| Penicillin | 48 | 655 | 3.1 (2.1 - 4.1) | 1,114 |
| Cefdinir | 55 | 601 | 2.8 (1.4 - 4.2) | 2,017 |
| Metronidazole | 40 | 458 | 2.2 (1.2 - 3.1) | 1,082 |
Estimates of ED visits for ADEs based on the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project (2011-2015); estimates of dispensed oral prescriptions from retail pharmacies based on the National Prescription Audit from QuintilesIMS (2011-2015). Drug products are not mutually exclusive; for some ED visits, more than one drug product was implicated in the ADE. Drug products are shown if they were implicated in ≥2% of estimated ED visits for antibiotic ADEs within each age group. Data exclude cases of unsupervised ingestion in which children aged ≤10 years accessed medications without caregiver oversight
Number needed to harm (NNH) calculated as the reciprocal of the estimated number of ED visits divided by the number of dispensed prescriptions.
Coefficient of variation >30%.