SAFETY SIGNAL DETECTION OF CARDIAC DISORDERS ADVERSE DRUG EVENTS FOR AZITHROMYCIN IN PEDIATRIC POPULATION USING HEALTH CANADA ADVERSE EVENT REPORTING SYSTEM DATABASE

Objective: We conducted signal detection of adverse drug events reported in Health Canada adverse event reporting system database “MedEffect” for azithromycin, a macrolide derivative and the first azalide antimicrobial agent to review the cardiac disorders adverse drug events (ADEs) in pediatric population with the drug labels of selected countries including India, USA, UK, Canada, Switzerland, Australia, New Zealand.Methods: We extracted data between January 1965 and June 2016 from the Canada adverse event reporting system database “MedEffect”. Frequentist and Bayesian methods were used to calculate disproportionality distribution of drug-adverse event (AE) pairs. The AE which was detected by all the three indices of proportional reporting ratio (PRR), reporting odds ratio (ROR), and information component (IC) was identified as a potential signal. AE reports for azithromycin, among which 3651 reports were attributed to paediatrics.Results: The signal detected by PRR and ROR for tachycardia associated with azithromycin were found to be 1.3 and for cardiovascular disorder were 1.2. The IC for azithromycin by a Bayesian method was 0.3 for both, tachycardia and cardiovascular disorder. Both AEs of cardiovascular disorder and tachycardia were detected as potential signals of azithromycin for the paediatric population. Comparing drug labels of 7 countries in paediatric population, both adverse events were not listed on any of the labels of seven countries against the pediatric population.Conclusion: We detected 2 new potential signals of azithromycin which were not listed on the labels of 7 countries. Therefore, it should be accompanied by a signal evaluation including causal association, clinical significance, and preventability.