Active surveillance of drug safety and influential factors in pediatric patients with Mycoplasma pneumoniae pneumonia
- VernacularTitle:肺炎支原体肺炎患儿药物治疗安全性的主动监测及影响因素研究
- Author:
Yuefeng WANG
1
;
Qiang GAO
1
;
Ke QIN
2
Author Information
1. Dept. of Pharmacy,Xinxiang Central Hospital/the Fourth Clinical College of Henan Medical University,Henan Xinxiang 453000,China
2. Xinxiang Institute for Food and Drug Control,Henan Xinxiang 453000,China
- Publication Type:Journal Article
- Keywords:
Mycoplasma pneumoniae pneumonia;
children;
adverse drug reaction;
safety;
influential factors
- From:
China Pharmacy
2025;36(22):2838-2844
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To analyze adverse drug reactions (ADRs) in pediatric patients with Mycoplasma pneumoniae pneumonia (MPP), and investigate the influential factors associated with the occurrence of ADRs. METHODS Clinical records of pediatric patients with MPP in Xinxiang Central Hospital (hereinafter referred to as “our hospital”) from Oct. 1st, 2023 to Sept. 30th, 2024 collected from the Hospital Information System were retrospectively reviewed using the global trigger tool (GTT). The positive triggers were further reviewed to confirm the occurrence of ADRs, and the characteristics of those ADRs were analyzed. The children were divided into the ADR group and the non-ADR group. Univariate analysis and multivariate Logistic regression analysis were performed to investigate the potential influential factors for ADRs in MPP children. RESULTS A total of 1 325 MPP children were included. Out of 24 designed triggers, 14 were positive, with a positive trigger rate of 58.3%. There were 1 301 positive trigger cases, involving 846 pediatric patients. After assessment, 399 cases of ADRs were identified in 372 pediatric patients, yielding a positive predictive value of triggers at 30.7%. The main types of ADRs were abnormal blood cells (230 cases, 57.6%), skin and its appendages damage (78 cases, 19.5%), and gastrointestinal system damage (42 cases, 10.5%), which predominantly occurred 4 days or more, within 2-3 days and within 2-3 days after medication, respectively. They were more prevalent in pediatric patients aged>3-10 years (295 cases, 79.3%). The major categories of drugs associated with ADRs included intravenous corticosteroids (209 cases), cephalosporins (180 cases), macrolides (38 cases), tetracyclines (28 cases) and traditional Chinese medicine (TCM) injections (28 cases). These ADR reports were classified into 3 types: 1 serious case, 394 general cases and 4 new cases. In terms of causality assessment, 1 case was assessed as certain, 19 cases as probable, and 379 cases as possible. In terms of ADR outcomes, 151 cases fully recovered, while the outcomes for 248 cases remained unknown. Univariate analysis and multivariate Logistic regression analysis revealed that a history of allergies [OR=5.231, 95%CI (2.004, 13.656), P<0.05], the number of medications used [OR=1.064, 95%CI (1.027, 1.103), P<0.05], and intravenous corticosteroid administration [OR=3.223, 95%CI (2.341, 4.437), P<0.05] were independent risk factors of ADRs in pediatric patients with MPP. The use of azithromycin [OR=0.544, 95%CI (0.376, 0.786), P<0.05] was identified as an independent protective factor against the occurrence of ADRs in pediatric patients with MPP. CONCLUSIONS Children with MPP in our hospital exhibit a higher incidence of ADRs, primarily involving abnormal blood cells, skin and its appendages damage, and gastrointestinal system damage. A history of allergies, the number of medications used, intravenous corticosteroid administration, and the use of azithromycin are associated with the occurrence of ADR in MPP pediatric patients.