Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
Department of Pharmacology, RD Gardi Medical College, Ujjain, India.
BMJ Open. 2021 Oct 4;11(10):e052737. doi: 10.1136/bmjopen-2021-052737.
To analyse and present the occurrence and severity of spontaneous adverse drug reaction (ADR) reports prospectively registered at an ADR monitoring centre (AMC) in Central India.
The survey was conducted between 2013 and 2019 at an ADR Monitoring Centre in Central India. ADRs were recorded using the standard 'Suspected ADR Reporting form'.
The causality of the ADRs were categorised using the WHO causality assessment scale to assess the relationship between a drug and the occurrence of an ADR.
Totally 1980 spontaneous ADRs were reported involving 960 patients and 1316 drugs prescriptions. The occurrence of ADRs was common among male patients (64%) and patients of age between 19 and 65 years (81%). Antimicrobials caused 29% ADRs, followed by drugs of antiretroviral therapy (19%). Zidovudine caused most ADRs (88%) followed by ethambutol and ciprofloxacin. The ADRs of skin and subcutaneous tissue disorders (28%) were most common among all system organ classes followed by gastrointestinal systems (18%). Four per cent of all reported ADRs were severe. A peak of ADR reports was attained in 2016 with 224 reports, which decreased to 127 in 2019.
A high number of ADRs caused by antimicrobials is an alarming situation, which adds up to antimicrobial resistance. Judicious use of antimicrobials is yet again proven as need of the hour. Under-reporting of ADRs is evident in our study and is a major factor for the delay in the withdrawal of drugs responsible for causing ADRs. Interventions in terms of training and feedback are suggested to encourage and improve ADR reporting.
分析和呈现在印度中部的一个药物不良反应监测中心前瞻性注册的药物不良反应报告的发生和严重程度。
这项调查是在印度中部的一个药物不良反应监测中心进行的,时间为 2013 年至 2019 年。使用标准的“疑似药物不良反应报告表”记录药物不良反应。
使用世界卫生组织因果关系评估量表对药物不良反应的因果关系进行分类,以评估药物与药物不良反应发生之间的关系。
共报告了 1980 例自发性药物不良反应,涉及 960 名患者和 1316 种药物处方。药物不良反应的发生在男性患者(64%)和年龄在 19 至 65 岁之间的患者中较为常见(81%)。抗菌药物引起的药物不良反应占 29%,其次是抗逆转录病毒治疗药物(19%)。齐多夫定引起的药物不良反应最多(88%),其次是乙胺丁醇和环丙沙星。在所有系统器官类别中,皮肤和皮下组织疾病(28%)的药物不良反应最为常见,其次是胃肠道系统(18%)。所有报告的药物不良反应中有 4%为严重。2016 年报告的药物不良反应达到峰值,有 224 例,2019 年降至 127 例。
抗菌药物引起的大量药物不良反应是一个令人担忧的情况,这增加了对抗菌药物耐药性的担忧。合理使用抗菌药物再次被证明是当前的迫切需要。我们的研究中明显存在药物不良反应报告不足的情况,这是导致延迟撤回引起药物不良反应的药物的一个主要因素。建议采取培训和反馈等干预措施,鼓励和改善药物不良反应报告。