Atlanta—Amoxicillin is the most likely antibiotic to send children aged 9 years and younger to the emergency department (ED), while sulfamethoxazole/trimethoprim was most likely to cause adverse drug events requiring emergency care in those aged 10 to 19 years old, a new study reports.

The analysis in the Journal of the Pediatric Infectious Diseases Society details how antibiotics led to nearly 70,000 estimated ED visits in the United States each year from 2011 to 2015 for allergic reactions and other adverse effects in children and adolescents.

“For parents and other caregivers of children, these findings are a reminder that while antibiotics save lives when used appropriately, antibiotics also can harm children and should only be used when needed,” explained lead author Maribeth C. Lovegrove, MPH, Division of Healthcare Quality Promotion at the CDC. “For healthcare providers, these findings are a reminder that adverse effects from antibiotics are common and can be clinically significant and consequential for pediatric patients.”

Researchers compared nationwide estimates for outpatient antibiotic prescriptions and to ED visits attributed to the use of antibiotics by youths 19 and younger, using data from a nationally representative sample of hospitals.

Allergic reactions, including rash, pruritus or angioedema were most common, making up 86% of the visits. As for which children had the greatest risk of needing emergency care for an antibiotic reaction, the study reported that 41% of the pediatric patients presenting to EDs were aged 2 years or younger.

Complicating matters, according to the article, is that at least a third of outpatient pediatric prescriptions for antibiotics have been found to be unnecessary. With the new data on the immediate risks to patients, Lovegrove advised in a Pediatric Infectious Disease Society press release, that “Clinicians, and parents and caregivers, can better weigh the risks and benefits of antibiotic treatment.”

Study authors suggest that educating prescribers on the risks of antibiotic adverse drug effects could help reduce unnecessary prescribing. They recommend that prevention efforts should focus on pediatric patients are at the greatest risk of harm.

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