Antibiotic Use Linked to Emergency Room Visits

According to the results of a study reported in the September 15 issue of Clinical Infectious Diseases, allergic reactions to antibiotics account for many visits to the Emergency Room. Nadine Shehab, from the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, and colleagues, write "Drug-related adverse events are an underappreciated consequence of antibiotic use, and the national magnitude and scope of these events have not been studied."

The combination of untoward events associated with antibiotics; in addition to the ever-increasing incidence of antibiotic resistant diseases, makes judicious use of antibiotics a focus for healthcare providers.

Adverse events associated with sulfonamides and clindamycin landed patients in the emergency room most frequently, according to the research results. Penicillin and cephalosporins accounted for the highest incidence of allergic reactions. Sulfa drugs and fluoroquinalones (Cipro, Floxin, Tequin and Levaquin to name a few) were the primary culprits leading to neurologic and psychiatric complaints.

The authors suggest that, “Minimizing unnecessary antibiotic use by even a small percentage could significantly reduce the immediate and direct risks of drug-related adverse events in individual patients."

In an accompanying editorial, Jeffrey A. Linder, from Brigham and Women's Hospital and Harvard Medical School in Boston says that most clinicians in the US greatly exceed current guidelines when doling out antibiotic prescriptions. He says, "The decision and discussion about antibiotic prescribing should focus on benefits and risks for the individual patient. For an individual patient, the risks are greater than the benefits, and the discussion should stop there."

Clin Infect Dis. 2008;47:735-743, 744-746


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