Background Paediatric patients are one of the population groups with the highest risk of medication error. Their characterisation will allow us to develop strategies to prevent these and improve the safety of patients.
Purpose To characterise the incidents associated with the use of antibiotics in paediatric patients who present in the Emergency Department (ED): identify the drugs, categorise types and causes of errors, determine the severity and analyse the factors that influence its occurrence.
Material and methods A prospective observational study of the incidents detected in the ED during a period of 3 months in 2017. For data collection, a form was used that included: demographic data of the patient, medication involved, type of error or adverse event, severity, causes and latent factors, process of the therapeutic chain where the error occurred and trigger tools for detection.
Results There were 15 504 visits to the ED during the study period, among which were detected 65 incidents related to medication (incidence=0.4%). Forty-nine per cent were related to the use of antibiotics. The drugs reported were amoxicillin (n=13), amoxicillin-clavulanic (n=10), azithromycin (n=5), cefuroxime-axethyl (n=1), phenoxybenzylpenicillin (n=1) and metronidazole (n=1). Incidents were classified as non-preventable adverse events (9.4%), detected by warning signs (diarrhoea, skin rash and hypersensitivity reaction) and medication errors (90.6%). Of the total errors, 97% were in the prescribing process: 13 cases for underdosing, three cases for overdose and in 12 cases the medication was not indicated for diagnosis. A single case was in the dosing default administration process. In 48% of cases, the error reached the patient but did not cause damage and in 52% the error caused temporary damage to the patient and required treatment or intervention. The latent factors described in 87% of the cases were lack of knowledge and training about the medication, and lack of follow-up of clinical guidelines.
Conclusion A high number of incidents related to antibiotic treatment have been observed in paediatric patients, mostly on prescription. We recommend the development of joint therapeutic guides between Primary Health Care and specialised care aimed at the safe use of antibiotics, focusing on the adequacy of the antibiotic and the dose based on the infectious process.
No conflict of interest
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