Background Prescribing a drug for a child is not a simple task because children pose distinct challenges for healthcare professionals in prescribing, dispensing, and administering any drug. Published studies investigating pediatric adverse drug events (ADEs) showed that drug ordering is the main stage of the medication process where ADEs originate and accounts for 79% of ADEs, of which 34% are related to incorrect dosing. It has been recognized that computerized physician order entry (CPOE) can reduce medication errors in adult and pediatric populations.

Methods An observational prospective cohort study was conducted on all pediatric patients aged 0–14 years admitted during the study periods to pediatric wards over a 3-month period. All reported drug-related problems (DRPs) were validated using the same method used in our previous published studies. DRPs were peer-reviewed by an expert panel consisting of a pediatrician, clinical pharmacist, and researcher. A final decision regarding validation of a DRP case was made by consensus after discussion within the group. Once a DRP was validated, the panel also assessed it for severity and preventability.

Results 657 pediatric patients were included. Of these, 235 patients suffered from 328 DRPs. Overall DRP incidence was 35.8% (95% CI 32.1–39.6). Almost all identified DRPs were deemed preventable (99.7%) and 95.1% (n=312) were moderate in severity. The most frequently reported diagnoses were bronchiolitis/pneumonia (n=32). Nearly half (328 [49.9%] of 657) of patients experienced at least one DRP. The percentage of male patients with DRPs (190 [58%] of 328) was higher than the percentage of female patients with DRPs (138 [42%] of 328). However, there was no significant difference in DRP incidence between male and female patients (p=0.239). The highest DRP incidence reported on the medical ward was 32.3% (95% CI 27.3–37.3). The most frequently involved drug classes in DRPs were antimicrobial medications (n=62), followed by respiratory medications (n=41), gastrointestinal drugs (n=21), vitamins (n=14), steroids (n=9), and nonsteroidal anti-inflammatory drugs (NSAIDs; n=8). Using the significance level of 0.05, no significant difference was found in DRP percentages before and after CPOE use (p=0.472).

Conclusion DRPs in hospitalized pediatric patients are common. The vast majority were assessed as moderate in severity and deemed preventable. In this study, the majority of DRPs reported were related to dosing and drug choice problems. Further study is needed to investigate the DRPs associated with off-label use of medication in children.