An article in the October issue of Pediatrics raises more questions than it answers. Boston medical researchers took a look at bad reactions children and teens had to prescribed medicines over a ten year period, 1995 – 2005.
According to the abstract, the researchers used data from the National Center for Health Statistics, which collects information on patient visits tooutpatient clinics and emergency departments throughout theUnited States. They then estimatedthe national incidence of adverse drug events (ADEs) requiring medical treatment (including hospitalizations),described the pediatric population seeking care for ADEs, andcharacterized the events in terms of patient symptoms and medicationsimplicated.
The authors found that out of nearly 600,000 annual ADE-related visits to clinics and hospitals, children aged O to 4 had the highest incidence of medical visits connected to adverse drug events. The most common symptoms these children had were dermatologic conditions (presumably rashes and such) and gastrointestinal symptoms. The most frequent medicinal culprits in these cases were antimicrobial agents (antibiotics), central nervous system agents and hormones. The latter two increased in frequency among older children, ages 5-11 and 12-18.
Two questions come to mind here:
(1) Medical personnel use antibiotics to treat a variety of illnesses, some of which may or may not be bacterially-caused. A doctor may start a child on antibiotics for what looks like strep throat, for example, before the culture results even come back. So if that suspected strep throat is actually a virus of another stripe that includes nausea, how would a researcher know whether the stomach upset is related to an adverse reaction to the drug taken or the virus itself?
(2) The incidence of increased ADEs due to prescribed hormones include clinic visits and/or hospitalizations of teenagers who are taking birth control pills. This is according to an Associated Press story about this study, which CBSNews.com published today. According to the AP story, “Bad reactions to these pills included menstrual problems, nausea and vomiting,” But what if a teen gets a contraceptive prescription primarily to regulate periods or to counter other menstrual cycle irregularities that already include nausea, cramping, etc? How would a researcher parse that info to separate the ADEs from the symptoms that may already be occurring?
Just my restless mind grabbing onto an interesting study on this Monday morning. You can read the study abstract at the Pediatrics website. You can also take a look at the AP story on CBSNews.com on the study and decide for yourself.
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