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Endotoxin-Like Reactions With Intravenous Gentamicin Results From Pharmacovigilance Tools Under Investigation

Published online by Cambridge University Press:  21 June 2016

Manfred Hauben  and
Lester Reich
Manfred Hauben
Affiliation:
Risk Management Strategy, Pfizer, Inc., New York, New York Division of Clinical Pharmacology, New York University School of Medicine, New York Departments of Community and Preventive Medicine and Pharmacology, New York Medical College, Valhalla, New York
Lester Reich*
Affiliation:
Risk Management Strategy, Pfizer, Inc., New York, New York Departments of Community and Preventive Medicine and Pharmacology, New York Medical College, Valhalla, New York
*
Risk Management Strategy, Pfizer, Inc., 235 E. 42nd Street, New York, NY 10017[email protected]
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Abstract

Objective:

To apply two data mining algorithms (DMAs) to Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) reports that involved endotoxin-like reactions with intravenous gentamicin to determine whether a signal of disproportionate reporting of these events would have been generated concurrently with surveillance based on clinical observation.

Design:

Multi-item gamma-Poisson shrinker (MGPS) and proportional reporting ratios (PRRs) were used. Data used for data mining consisted of an extract of the FDA AERS database. Previously published details of clusters of endotoxin-like reactions to intravenous gentamicin were used to select adverse events for data mining.

Results:

The first signal of disproportionate reporting with any relevant event occurred in 1998, the year in which the outbreak was identified and evaluated by the Centers for Disease Control and Prevention and the FDA. In 1997, there were only 6 reports of rigors in the AERS; this jumped to 68 in 1998. In 1998, a signal was generated for endotoxic shock with PRRs but not with MGPS, based on one case.

Conclusions:

The two DMAs generated signals concurrently with the influx of reports. It would have been difficult for safety reviewers to ignore an increase in rigors by traditional methods of safety surveillance; therefore, DMAs might not have had a great deal to offer in this instance. If data mining were considered as a second-line defense to diligent clinical observations under similar circumstances, simple disproportionality methods such as PRRs might be more useful than DMAs such as MGPS when commonly cited thresholds are used.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 4 , April 2005 , pp. 391 - 394
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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