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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Adverse drug reactions in adult medical inpatients in a South African hospital serving a community with a high HIV/AIDS prevalence: Prospective observational study
British Journal of Clinical Pharmacology, Volume 65, No. 3, Year 2008
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Description
Aims: To describe the frequency, nature and preventability of community-acquired and hospital-acquired adverse drug reactions (ADRs) in a South African hospital serving a community with a high prevalence of human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome. Methods: A 3-month prospective observational study of 665 adults admitted to two medical wards. Results: Forty-one (6.3%) patients were admitted as a result of an ADR and 41 (6.3%) developed an ADR in hospital. Many of the ADRs (46.2%) were considered preventable, although less likely to be preventable in HIV-infected patients than in those with negative or unknown HIV status (community-acquired ADRs 2/24 vs. 35/42; P < 0.0001; hospital-acquired ADRs 3/25 vs. 14/26; P = 0.003). Patients admitted with ADRs were older than patients not admitted with an ADR (median 53 vs. 42 years, P = 0.003), but 60% of community-acquired ADRs at hospital admission were in patients <60 years old. Among patients <60 years old, those HIV infected were more likely to be admitted with an ADR [odds ratio (OR) 2.32, 95% confidence interval (CI) 1.17, 4.61; P = 0.017]. Among HIV-infected patients, those receiving antiretroviral therapy (ART) were more likely to be admitted with an ADR than those not receiving ART (OR 10.34, 95% CI 4.50, 23.77; P < 0.0001). No ART-related ADRs were fatal. Antibiotics and drugs used for opportunistic infections were implicated in two-thirds of hospital-acquired ADRs. Conclusions: ADRs are an important, often preventable cause of hospitalizations and inpatient morbidity in South Africa, particularly among the elderly and HIV-infected. Although ART-related injury contributed to hospital admissions, many HIV-related admissions were among patients not receiving ART, and many ADRs were associated with medicines used for managing opportunistic infections. © 2007 The Authors.
Authors & Co-Authors
Mehta, Ushma C.
South Africa, Cape Town
University of Cape Town
Durrheim, David N.
Australia, Newcastle
Hunter Medical Research Institute, Australia
Blockman, Marc
South Africa, Cape Town
University of Cape Town
Kredo, Tamara J.
South Africa, Cape Town
University of Cape Town
Gounden, Ronald
South Africa, Cape Town
University of Cape Town
Barnes, Karen Irma
South Africa, Cape Town
University of Cape Town
Statistics
Citations: 139
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1111/j.1365-2125.2007.03034.x
ISSN:
03065251
e-ISSN:
13652125
Research Areas
Health System And Policy
Infectious Diseases
Violence And Injury
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study
Study Locations
South Africa