Adverse drug reaction reporting in a multicenter surveillance study.

Abstract

OBJECTIVE:

To evaluate the performance of a multicenter, prospective surveillance program in identifying adverse events, and to seek explanations for misclassification bias.

DESIGN:

The design was a prospective observational study of patients with documented or suspected bacterial pneumonia.

SETTING:

Data were collected in 74 acute care hospitals across the US.

PATIENTS:

This evaluation was based on a consecutive sample of 1822 adult patients (> 18 years of age) with documented or suspected bacterial pneumonia who were being treated with a cephalosporin, a penicillin, or an aminoglycoside over a 3-month period. Patients were followed for the duration of antibiotic therapy and were excluded if antibiotic therapy was < 3 days or if the pneumonia was judged to be nonbacterial.

INTERVENTIONS:

Clinical pharmacists documented patient demographics, concurrent illnesses and medications, antibiotic administration, relevant laboratory data, and the occurrence of nephrotoxicity and neutropenia.

MAIN OUTCOME MEASURES:

Validity of investigators' identification of neutropenia and nephrotoxicity as compared with objective laboratory data was assessed by using sensitivity, specificity, and positive and negative predictive value measures.

RESULTS:

Among the 1502 patients with sufficient data to evaluate neutropenia, there was agreement in 1270 patients (84.6%); likewise, among 1291 patients with sufficient data to evaluate nephrotoxicity there was agreement in 1186 patients (91.9%). Sensitivity of the researchers' assessments was 50.9% and 71.0% for neutropenia and nephrotoxicity, respectively. The negative predictive value was > 95% for both events.

CONCLUSIONS:

Overall, this evaluation demonstrated that the Drug Surveillance Network can successfully identify targeted adverse events. Moreover, this study highlights the importance of validation for all types of outcomes-oriented research studies.

• Authors: E G Timm, L S Welage, C A Walawander, J F Sayers, E L Karpiuk, T D Davis, T H Grasela Jr
• Journal: The Annals of pharmacotherapy (Ann Pharmacother) Vol. 29 Issue 3 Pg. 240-5 (Mar 1995) ISSN: 1060-0280 [Print] United States
• PMID: 7606067 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Anti-Bacterial Agents

Topics

• Adolescent
• Adult
• Adverse Drug Reaction Reporting Systems (standards)
• Aged
• Anti-Bacterial Agents (adverse effects)
• Female
• Humans
• Kidney Diseases (chemically induced)
• Male
• Middle Aged
• Multicenter Studies as Topic
• Neutropenia (chemically induced)
• Pharmacy Service, Hospital
• Pneumonia, Bacterial (drug therapy)
• Population Surveillance
• Program Evaluation
• Prospective Studies
• United States