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Table 4 Drug classes commonly implicated in serious ADRs and the associated ADR manifestations

From: Serious adverse drug reactions at two children’s hospitals in South Africa

Drug classSerious ADRs
Systemic antibacterials (J01), implicated in 12 serious ADRs• Diarrhoea with amoxicillin (2 cases) and with clarithromycin (1 case), prolonging the admissions
• Urticaria with phenoxymethylpenicillin (1 case) and with ceftriaxone (1 case), causing the admissions
• Maculo-papular rash with flucloxacillin, prolonging the admission
• Respiratory arrest with intravenous benzathine benzylpenicillin (medication error), fatal
• Red-man syndrome with vancomycin, near-fatal
• Thrombocytopaenia with amoxicillin, causing the admission
• Agranulocytosis with co-trimoxazole (and zidovudine), causing the admission
• Bicytopaenia with ceftriaxone, co-trimoxazole (and ganciclovir), prolonging the admission
• Metabolic acidosis with amikacin (and paracetamol), causing the admission
Systemic corticosteroids (H02), implicated in 6 serious ADRs• Lower respiratory tract infection with prednisone, causing the admission
• Upper respiratory tract infection with prednisone, causing the admission
Pneumocystis jirovecii pneumonia with prednisone and methylprednisolone, prolonging the admission
• Salmonellosis with prednisone (and mycophenolic acid), prolonging the admission
• Pancreatitis with prednisone and methylprednisolone, prolonging the admission
• Sepsis with methylprednisolone (and mycophenolic acid and tacrolimus), prolonging the admission
Psycholeptics (N05), implicated in 4 serious ADRs• Respiratory depression with chlorpromazine, lorazepam and diazepam (and phenobarbital), near-fatal
• Respiratory depression with diazepam (and morphine and phenobarbital), near-fatal
• Apnoea with midazolam, near-fatal
• Delirium with clozapine, causing the admission
Immunosuppressants (L04), implicated in 4 serious ADRs• Macrocytic anaemia with mycophenolic acid and tacrolimus, causing the admission
• Neutropaenic sepsis with tacrolimus, prolonging the admission
• Sepsis with mycophenolic acid and tacrolimus (and methylprednisolone), prolonging the admission
• Salmonellosis with mycophenolic acid (and prednisone), prolonging the admission
Direct-acting antivirals (J05), implicated in 4 serious ADRs• Agranulocytosis with zidovudine (and co-trimoxazole), causing the admission
• Diarrhoea with lopinavir-ritonavir, prolonging the admission
• Increased transaminases with efavirenz, prolonging the admission
• Bicytopaenia with ganciclovir (and ceftriaxone and co-trimoxazole), prolonging the admission
Analgesics (N02), implicated in 3 serious ADRs• Respiratory depression with morphine (and diazepam and phenobarbital), near-fatal
• Metabolic acidosis with paracetamol (and amikacin), causing the admission
• Increased paracetamol plasma concentration, prolonging the admission
  1. ADR adverse drug reaction