A study published in JAMA this week showed that antibiotics were the most common cause of adverse drug events in younger (age <65 years) patients presenting to the emergency departments of 58 sentinel hospitals in the US, and the second most common cause in those above 65 years of age. As a whole, an adverse drug event resulting in an ED visit was surprisingly common, estimated at 4 per 1,000 persons over the two years of the study (2013 and 2014).

Screenshot of the JAMA paper on adverse drug events resulting in ED visits in the USA

Do we have any local data? Yes, but not in the form of such a powerful data aggregation. Dr Derrick Aw showed in a single center study (NUH) that antibiotics were the most common cause of 42 severe cutaneous adverse reactions that were hospitalised over a 5-year period. In an older study (2004 to 2010) at SGH, 8 of 28 severe cutaneous drug reactions were attributed to antibiotics, just behind anticonvulsants as a cause of such reactions.

Statistically, most antibiotics are very safe drugs, with severe adverse events and reactions accounting for only a minute fraction of those receiving them, especially with respect to oral antibiotics. However, unlike the majority public perception, they are not entirely benign. It is testament to the huge amount of antibiotics consumed that they feature so prominently in this US study.

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Public Health, Singapore


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