Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 5 Lower Kent Ridge Road, Singapore.
Singapore Med J. 2009 Dec;50(12):1158-61.
Adverse drug reactions (ADRs) are a common medical problem in children, affecting up to 15 percent of children, according to the literature. However, most studies on ADRs were performed in a hospital setting, and studies in the general population are limited. The current study aims to estimate the prevalence of ADRs in a large number of non-selected Singaporean children.
School children, aged 7-16 years, from 25 random schools were screened via a self-reported questionnaire on ADRs, and parents of the selected children were then followed up with a telephone interview to obtain additional information on specific manifestations, diagnosis and allergy testing.
The prevalence of an ADR in children was 5.4 percent, with 56.7 percent of cases reporting an ADR to beta-lactam antibiotics. Dermal manifestations were reported in 60 percent of all ADRs, while multiple drug allergies accounted only for 3.8 percent. Only 6.9 percent of the children who experienced an ADR were referred to a hospital for further investigations.
ADRs were associated with a positive history of atopy, increased income level and Chinese and Indian ethnicity, but not with gender or age. It is striking that most children suffering from a clinical ADR were not investigated further or referred for diagnostic tests. Many parents were unaware of the availability of drug allergy tests and feared compromising their children's health. This certainly could attribute to the high incidence of the over-reporting of ADRs in the general population.
根据文献报道，药物不良反应（ADR）在儿童中较为常见，发生率高达 15%。然而，大多数 ADR 研究都是在医院环境中进行的，针对普通人群的研究较为有限。本研究旨在评估大量未选择的新加坡儿童中 ADR 的发生率。
从 25 所随机学校的 7-16 岁学龄儿童中，通过自我报告的 ADR 问卷进行筛选，并对选中的儿童的家长进行电话随访，以获取有关特定表现、诊断和过敏测试的更多信息。
儿童 ADR 的发生率为 5.4%，其中 56.7%的病例报告对β-内酰胺类抗生素有 ADR。所有 ADR 中，皮肤表现占 60%，而多种药物过敏仅占 3.8%。仅有 6.9%出现 ADR 的儿童被转介到医院进行进一步检查。
ADR 与特应性阳性史、较高的收入水平以及华人和印度裔有关，但与性别或年龄无关。令人惊讶的是，大多数出现临床 ADR 的儿童并未进一步接受调查或转介进行诊断性检查。许多家长不知道有药物过敏测试，并且担心会影响孩子的健康。这可能是导致普通人群中 ADR 过度报告发生率较高的原因之一。
