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Descriptive study of adverse drug reactions in a tertiary care pediatric hospital in México from 2014 to 2017
In Pediatrics, adverse drug reactions (ADRs) affect morbidity and mortality. In Mexico, the characteristics of ADRs and suspect drugs have not been described in hospitalized children. To estimate the frequency of ADRs and describe them, as well as suspect drugs, in a tertiary care pediatric hospital...
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Published in: | PloS one 2020, Vol.15 (3), p.e0230576 |
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creator | Morales-Ríos, Olga Cicero-Oneto, Carlo García-Ruiz, Carlos Villanueva-García, Dina Hernández-Hernández, Maribelle Olivar-López, Víctor Jiménez-Juárez, Rodolfo Norberto Jasso-Gutiérrez, Luis |
description | In Pediatrics, adverse drug reactions (ADRs) affect morbidity and mortality. In Mexico, the characteristics of ADRs and suspect drugs have not been described in hospitalized children.
To estimate the frequency of ADRs and describe them, as well as suspect drugs, in a tertiary care pediatric hospital in Mexico.
A total of 1,649 Hospital Infantil de Mexico Federico Gómez ADR reports were analyzed. Completeness of the information was assessed, and ADRs severity and seriousness were assigned based on NOM-220-SSA1-2012, with causality being established according to the Naranjo algorithm. ADRs were classified with WHO Adverse Drug Reaction Terminology (WHO-ART). The drugs involved in ADRs were categorized according to the Anatomical Therapeutic Chemical (ATC) classification. Descriptive analysis was performed using the SPSS 20 statistical package.
Of all the reports, 5.8% lacked sufficient information for the analysis (grade 0). ADRs frequency ranged from 2.12% to 8.07%. ADRs occurred most commonly in children (56.9%), in the female gender (52%), in subjects with normal BMI Z-score (46.6%) and malnutrition (35.3%), diagnosed with neoplasms (72.2%) and in the Emergency Department (70.0%). ADRs were severe in 14.4% of cases, in 81.0% they were serious and 2.1% were classified as definite. Most common serious ADR was febrile neutropenia (44.5%). The 0.7% of patients recovering with sequelae; 1.1% died (with the medication being associated) and 70.3% were admitted to the hospital as a result of an ADR. Antineoplastic and immunomodulating agents were more commonly associated with serious ADRs.
ADRs affected morbidity and mortality, which is why strengthening pharmacovigilance programs in Mexican pediatric hospitals is necessary. |
doi_str_mv | 10.1371/journal.pone.0230576 |
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To estimate the frequency of ADRs and describe them, as well as suspect drugs, in a tertiary care pediatric hospital in Mexico.
A total of 1,649 Hospital Infantil de Mexico Federico Gómez ADR reports were analyzed. Completeness of the information was assessed, and ADRs severity and seriousness were assigned based on NOM-220-SSA1-2012, with causality being established according to the Naranjo algorithm. ADRs were classified with WHO Adverse Drug Reaction Terminology (WHO-ART). The drugs involved in ADRs were categorized according to the Anatomical Therapeutic Chemical (ATC) classification. Descriptive analysis was performed using the SPSS 20 statistical package.
Of all the reports, 5.8% lacked sufficient information for the analysis (grade 0). ADRs frequency ranged from 2.12% to 8.07%. ADRs occurred most commonly in children (56.9%), in the female gender (52%), in subjects with normal BMI Z-score (46.6%) and malnutrition (35.3%), diagnosed with neoplasms (72.2%) and in the Emergency Department (70.0%). ADRs were severe in 14.4% of cases, in 81.0% they were serious and 2.1% were classified as definite. Most common serious ADR was febrile neutropenia (44.5%). The 0.7% of patients recovering with sequelae; 1.1% died (with the medication being associated) and 70.3% were admitted to the hospital as a result of an ADR. Antineoplastic and immunomodulating agents were more commonly associated with serious ADRs.
ADRs affected morbidity and mortality, which is why strengthening pharmacovigilance programs in Mexican pediatric hospitals is necessary.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0230576</identifier><identifier>PMID: 32208451</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acute Kidney Injury - etiology ; Adolescent ; Adult ; Adverse Drug Reaction Reporting Systems ; Algorithms ; Antineoplastic Agents - adverse effects ; Antineoplastic Agents - therapeutic use ; Biology and Life Sciences ; Body mass index ; Causality ; Child ; Child, Preschool ; Children ; Complications ; Drug-Related Side Effects and Adverse Reactions - epidemiology ; Drug-Related Side Effects and Adverse Reactions - mortality ; Drug-Related Side Effects and Adverse Reactions - pathology ; Drugs ; Emergency medical care ; Emergency medical services ; Female ; Gender ; Hospitals ; Hospitals, Pediatric ; Humans ; Infant ; Infant, Newborn ; Infectious diseases ; Male ; Malnutrition ; Medical diagnosis ; Medicine and Health Sciences ; Mexico - epidemiology ; Morbidity ; Mortality ; Neoplasms ; Neoplasms - diagnosis ; Neoplasms - drug therapy ; Neutropenia ; Patients ; Pediatrics ; Pharmaceutical industry ; Pharmacovigilance ; Sepsis ; Severity of Illness Index ; Sex Factors ; Side effects ; Terminology ; Tertiary Healthcare ; Young Adult</subject><ispartof>PloS one, 2020, Vol.15 (3), p.e0230576</ispartof><rights>2020 Morales-Ríos et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Morales-Ríos et al 2020 Morales-Ríos et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-aaf4c1f5a9bc557ba04f354628eca6bd5b772cf40f6f2019f2259a55379dc4ea3</citedby><cites>FETCH-LOGICAL-c526t-aaf4c1f5a9bc557ba04f354628eca6bd5b772cf40f6f2019f2259a55379dc4ea3</cites><orcidid>0000-0003-2525-1618</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2382605364/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2382605364?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,4024,25753,27923,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32208451$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Yang, Jinn-Moon</contributor><creatorcontrib>Morales-Ríos, Olga</creatorcontrib><creatorcontrib>Cicero-Oneto, Carlo</creatorcontrib><creatorcontrib>García-Ruiz, Carlos</creatorcontrib><creatorcontrib>Villanueva-García, Dina</creatorcontrib><creatorcontrib>Hernández-Hernández, Maribelle</creatorcontrib><creatorcontrib>Olivar-López, Víctor</creatorcontrib><creatorcontrib>Jiménez-Juárez, Rodolfo Norberto</creatorcontrib><creatorcontrib>Jasso-Gutiérrez, Luis</creatorcontrib><title>Descriptive study of adverse drug reactions in a tertiary care pediatric hospital in México from 2014 to 2017</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>In Pediatrics, adverse drug reactions (ADRs) affect morbidity and mortality. In Mexico, the characteristics of ADRs and suspect drugs have not been described in hospitalized children.
To estimate the frequency of ADRs and describe them, as well as suspect drugs, in a tertiary care pediatric hospital in Mexico.
A total of 1,649 Hospital Infantil de Mexico Federico Gómez ADR reports were analyzed. Completeness of the information was assessed, and ADRs severity and seriousness were assigned based on NOM-220-SSA1-2012, with causality being established according to the Naranjo algorithm. ADRs were classified with WHO Adverse Drug Reaction Terminology (WHO-ART). The drugs involved in ADRs were categorized according to the Anatomical Therapeutic Chemical (ATC) classification. Descriptive analysis was performed using the SPSS 20 statistical package.
Of all the reports, 5.8% lacked sufficient information for the analysis (grade 0). ADRs frequency ranged from 2.12% to 8.07%. ADRs occurred most commonly in children (56.9%), in the female gender (52%), in subjects with normal BMI Z-score (46.6%) and malnutrition (35.3%), diagnosed with neoplasms (72.2%) and in the Emergency Department (70.0%). ADRs were severe in 14.4% of cases, in 81.0% they were serious and 2.1% were classified as definite. Most common serious ADR was febrile neutropenia (44.5%). The 0.7% of patients recovering with sequelae; 1.1% died (with the medication being associated) and 70.3% were admitted to the hospital as a result of an ADR. Antineoplastic and immunomodulating agents were more commonly associated with serious ADRs.
ADRs affected morbidity and mortality, which is why strengthening pharmacovigilance programs in Mexican pediatric hospitals is necessary.</description><subject>Acute Kidney Injury - etiology</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Adverse Drug Reaction Reporting Systems</subject><subject>Algorithms</subject><subject>Antineoplastic Agents - adverse effects</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Biology and Life Sciences</subject><subject>Body mass index</subject><subject>Causality</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Complications</subject><subject>Drug-Related Side Effects and Adverse Reactions - epidemiology</subject><subject>Drug-Related Side Effects and Adverse Reactions - mortality</subject><subject>Drug-Related Side Effects and Adverse Reactions - pathology</subject><subject>Drugs</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Female</subject><subject>Gender</subject><subject>Hospitals</subject><subject>Hospitals, Pediatric</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Malnutrition</subject><subject>Medical diagnosis</subject><subject>Medicine and Health Sciences</subject><subject>Mexico - epidemiology</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Neoplasms</subject><subject>Neoplasms - diagnosis</subject><subject>Neoplasms - drug therapy</subject><subject>Neutropenia</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Pharmaceutical industry</subject><subject>Pharmacovigilance</subject><subject>Sepsis</subject><subject>Severity of Illness Index</subject><subject>Sex Factors</subject><subject>Side effects</subject><subject>Terminology</subject><subject>Tertiary Healthcare</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptUktuFDEUbCEQCYEbILDEhs0Mbv97gxSFX6QgNrC2XrufJx71tBvbPSJH4hy5WHoykyhBrJ5lV5VflaqqXtd0WXNdf1jHKQ3QL8c44JIyTqVWT6rjuuFsoRjlTx-cj6oXOa8pldwo9bw64oxRI2R9XA2fMLsUxhK2SHKZuisSPYFuiykj6dK0IgnBlRCHTMJAgBRMJUC6Ig4SkhG7ACUFRy5jHkOBfof6fv33T3CR-BQ3hNFakBJ3U7-snnnoM746zJPq15fPP8--LS5-fD0_O71YOMlUWQB44WovoWmdlLoFKjyXQjGDDlTbyVZr5rygXvlZtvGMyQak5LrpnEDgJ9Xbve7Yx2wPUWXLuGFqTkGJGXG-R3QR1nZMYTN7shGCvb2IaWVhNup6tK7BzlBmqIdOMIpG1Y6amopW6dYYNWt9PPw2tRvsHA4lQf9I9PHLEC7tKm6tpg1rjJwF3h8EUvw9YS52E7LDvocB43S7N59T1I2Zoe_-gf7fndijXIo5J_T3y9TU7upzx7K7-thDfWbam4dG7kl3feE3sT7DjA</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>Morales-Ríos, Olga</creator><creator>Cicero-Oneto, Carlo</creator><creator>García-Ruiz, Carlos</creator><creator>Villanueva-García, Dina</creator><creator>Hernández-Hernández, Maribelle</creator><creator>Olivar-López, Víctor</creator><creator>Jiménez-Juárez, Rodolfo Norberto</creator><creator>Jasso-Gutiérrez, Luis</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-2525-1618</orcidid></search><sort><creationdate>2020</creationdate><title>Descriptive study of adverse drug reactions in a tertiary care pediatric hospital in México from 2014 to 2017</title><author>Morales-Ríos, Olga ; Cicero-Oneto, Carlo ; García-Ruiz, Carlos ; Villanueva-García, Dina ; Hernández-Hernández, Maribelle ; Olivar-López, Víctor ; Jiménez-Juárez, Rodolfo Norberto ; Jasso-Gutiérrez, Luis</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c526t-aaf4c1f5a9bc557ba04f354628eca6bd5b772cf40f6f2019f2259a55379dc4ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acute Kidney Injury - etiology</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Adverse Drug Reaction Reporting Systems</topic><topic>Algorithms</topic><topic>Antineoplastic Agents - adverse effects</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Biology and Life Sciences</topic><topic>Body mass index</topic><topic>Causality</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Complications</topic><topic>Drug-Related Side Effects and Adverse Reactions - epidemiology</topic><topic>Drug-Related Side Effects and Adverse Reactions - mortality</topic><topic>Drug-Related Side Effects and Adverse Reactions - pathology</topic><topic>Drugs</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Female</topic><topic>Gender</topic><topic>Hospitals</topic><topic>Hospitals, Pediatric</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Malnutrition</topic><topic>Medical diagnosis</topic><topic>Medicine and Health Sciences</topic><topic>Mexico - epidemiology</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Neoplasms</topic><topic>Neoplasms - diagnosis</topic><topic>Neoplasms - drug therapy</topic><topic>Neutropenia</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Pharmaceutical industry</topic><topic>Pharmacovigilance</topic><topic>Sepsis</topic><topic>Severity of Illness Index</topic><topic>Sex Factors</topic><topic>Side effects</topic><topic>Terminology</topic><topic>Tertiary Healthcare</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morales-Ríos, Olga</creatorcontrib><creatorcontrib>Cicero-Oneto, Carlo</creatorcontrib><creatorcontrib>García-Ruiz, Carlos</creatorcontrib><creatorcontrib>Villanueva-García, Dina</creatorcontrib><creatorcontrib>Hernández-Hernández, Maribelle</creatorcontrib><creatorcontrib>Olivar-López, Víctor</creatorcontrib><creatorcontrib>Jiménez-Juárez, Rodolfo Norberto</creatorcontrib><creatorcontrib>Jasso-Gutiérrez, Luis</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Database (1962 - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morales-Ríos, Olga</au><au>Cicero-Oneto, Carlo</au><au>García-Ruiz, Carlos</au><au>Villanueva-García, Dina</au><au>Hernández-Hernández, Maribelle</au><au>Olivar-López, Víctor</au><au>Jiménez-Juárez, Rodolfo Norberto</au><au>Jasso-Gutiérrez, Luis</au><au>Yang, Jinn-Moon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Descriptive study of adverse drug reactions in a tertiary care pediatric hospital in México from 2014 to 2017</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2020</date><risdate>2020</risdate><volume>15</volume><issue>3</issue><spage>e0230576</spage><pages>e0230576-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>In Pediatrics, adverse drug reactions (ADRs) affect morbidity and mortality. In Mexico, the characteristics of ADRs and suspect drugs have not been described in hospitalized children.
To estimate the frequency of ADRs and describe them, as well as suspect drugs, in a tertiary care pediatric hospital in Mexico.
A total of 1,649 Hospital Infantil de Mexico Federico Gómez ADR reports were analyzed. Completeness of the information was assessed, and ADRs severity and seriousness were assigned based on NOM-220-SSA1-2012, with causality being established according to the Naranjo algorithm. ADRs were classified with WHO Adverse Drug Reaction Terminology (WHO-ART). The drugs involved in ADRs were categorized according to the Anatomical Therapeutic Chemical (ATC) classification. Descriptive analysis was performed using the SPSS 20 statistical package.
Of all the reports, 5.8% lacked sufficient information for the analysis (grade 0). ADRs frequency ranged from 2.12% to 8.07%. ADRs occurred most commonly in children (56.9%), in the female gender (52%), in subjects with normal BMI Z-score (46.6%) and malnutrition (35.3%), diagnosed with neoplasms (72.2%) and in the Emergency Department (70.0%). ADRs were severe in 14.4% of cases, in 81.0% they were serious and 2.1% were classified as definite. Most common serious ADR was febrile neutropenia (44.5%). The 0.7% of patients recovering with sequelae; 1.1% died (with the medication being associated) and 70.3% were admitted to the hospital as a result of an ADR. Antineoplastic and immunomodulating agents were more commonly associated with serious ADRs.
ADRs affected morbidity and mortality, which is why strengthening pharmacovigilance programs in Mexican pediatric hospitals is necessary.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32208451</pmid><doi>10.1371/journal.pone.0230576</doi><orcidid>https://orcid.org/0000-0003-2525-1618</orcidid><oa>free_for_read</oa></addata></record> |
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issn | 1932-6203 1932-6203 |
language | eng |
recordid | cdi_plos_journals_2382605364 |
source | PubMed Central Free; Publicly Available Content (ProQuest) |
subjects | Acute Kidney Injury - etiology Adolescent Adult Adverse Drug Reaction Reporting Systems Algorithms Antineoplastic Agents - adverse effects Antineoplastic Agents - therapeutic use Biology and Life Sciences Body mass index Causality Child Child, Preschool Children Complications Drug-Related Side Effects and Adverse Reactions - epidemiology Drug-Related Side Effects and Adverse Reactions - mortality Drug-Related Side Effects and Adverse Reactions - pathology Drugs Emergency medical care Emergency medical services Female Gender Hospitals Hospitals, Pediatric Humans Infant Infant, Newborn Infectious diseases Male Malnutrition Medical diagnosis Medicine and Health Sciences Mexico - epidemiology Morbidity Mortality Neoplasms Neoplasms - diagnosis Neoplasms - drug therapy Neutropenia Patients Pediatrics Pharmaceutical industry Pharmacovigilance Sepsis Severity of Illness Index Sex Factors Side effects Terminology Tertiary Healthcare Young Adult |
title | Descriptive study of adverse drug reactions in a tertiary care pediatric hospital in México from 2014 to 2017 |
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