Unnecessary antibiotic prescribing increases risk of adverse drug events

Approximately 50% of hospitalised patients receive at least one antibiotic during their hospital stay. However, estimates of the incidence of antibiotic-associated adverse drug events (ADEs) is generally unavailable.

In a cohort study published in JAMA Internal Medicine
^[1]
(online, 12 June 2017), data from 1,488 adult inpatients were examined for 30 days after antibiotic initiation for the development of antibiotic-associated ADEs, such as gastrointestinal, cardiac or neurologic events, and 90 days for the development of Clostridium difficile infection or new multidrug-resistant organism infections.

During that time, 20% of patients experienced at least one antibiotic-associated ADE. Furthermore, 20% of non-clinically indicated antibiotic regimens were associated with an ADE. Of the antibiotic-associated ADEs, 97% were considered clinically significant because of: new hospitalisations (3%); prolonged hospitalisations (24%); additional clinic or emergency department visits (9%); and additional laboratory tests, electrocardiograms or imaging (61%).

The findings highlight the importance of avoiding unnecessary antibiotic prescribing to reduce the potential harm from antibiotic-associated ADEs, the researchers conclude.