Seven of the top ten drugs causing adverse drug events in children that lead to emergency room visits are antibiotics.

What’s the Cost of Antibiotic Related ER Visits?

ER visits average about $2000 each, so the total cost of ER visits for antibiotic side effects may have been around $700 million. And again, at least one third of antibiotic prescriptions given to children are unnecessary. And more than $200 million of unnecessary ER costs.

On the one hand, a total of 350,000 emergency visits is a relatively small number compared to the 370 million antibiotic prescriptions given to children during that same period. Only about 0.1% of the time that an antibiotic prescription is taken by a child, does that child ends up in the ER. And the added ER cost is only about an extra $2 per antibiotic prescription.

But this represents around 140 million real dollars every year and almost 70,000 emergency visits every year, about 40% of them for children under age two. These are real children, not just numbers. These are real parents who were concerned enough about their kids to brave the cost and time and hassle of an emergency visit.

Antibiotic Related ER Visits are the Tip of the Iceberg

And emergency visits are only the tip of the iceberg. When a child is seen for an adverse drug event, only about 12% of the time are they taken to an emergency department. But 78% of the visits are to different waiting rooms: doctor’s offices, outpatient clinics, or urgent care centers.

Not to mention the tens of millions of times antibiotics caused uncomfortable side effects that didn’t lead to a medical visit. Or the long-term problem of antibiotic resistance, fueled by antibiotic overuse, which has become “one of the most urgent threats to public health.”

Antibiotics are some of our most wonderful medications. I am hugely grateful for them. And want to protect them. And our kids.

Whenever we can get the job done with gentler remedies, we all win.

References (last accessed August 26, 2018):

US Emergency Department Visits for Adverse Drug Events From Antibiotics in Children, 2011–2015. Journal of the Pediatric Infectious Diseases Society, piy066, 23 August 2018.

Pediatric adverse drug events in the outpatient setting: an 11-year national analysis. Pediatrics. 2009 Oct;124(4):e744-50. doi: 10.1542/peds.2008-3505.

US emergency department visits for outpatient adverse drug events, 2013-2014.” JAMA   316(20): 2115-2125. 2016

Cost of ER visits increased 31% between 2012-16: 5 findings. Becker’s Hospital Review 2018.

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Alan Greene MD contributor

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