JAMA

Older adults at higher risk of severe drug reactions from common antibiotics

August 12, 2024

Oral antibiotics, particularly sulfonamides and cephalosporins, are associated with a higher incidence of serious cutaneous adverse drug reactions (cADRs) when compared with macrolides, highlighting the need to consider lower-risk alternatives when possible.

Researchers identified 21,758 older adults (median age, 75 years; 64.1% female) during a 20-year study period who had an ED visit or hospitalization for serious cADRs following antibiotic therapy and 87,025 matched controls who didn't.

Key findings:

• Sulfonamide antibiotics and cephalosporins showed the strongest association with serious cADRs, with adjusted odds ratios of 2.9 and 2.6, respectively. These antibiotics also had a higher crude rate of ED visits or hospitalization.
• Nitrofurantoin, penicillins, and fluoroquinolones also demonstrated increased risks, albeit to a lesser extent.
• Hospitalized patients had a median stay of 6 days, with 9.6% requiring critical care and 5.3% resulting in mortality.

Source:

Lee EY, et al. (2024, August 8). JAMA. Oral Antibiotics and Risk of Serious Cutaneous Adverse Drug Reactions. https://pubmed.ncbi.nlm.nih.gov/39115856/