The vast majority of chemotherapy errors identified in children reach patients, according to one of the first epidemiological studies of cancer drug errors in children. Published in the July 1, 2007 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the study concluded that the antimetabolite class of chemotherapeutic agents are most likely associated with errors, and that errors in drug administration and errors in drug dosing and frequency were the most common mistakes made and consequently, the most potentially harmful.
Chemotherapeutic drugs have been credited with significant gains in survival from pediatric cancers. However, they are among the most toxic medications used today. Calculating dose, route, and frequency, which are often based on a childs weight, are critical to ensure that the drug concentration in the blood is within its narrow safety margins.
Medication errors are common during pediatric hospitalizations, occurring in almost 6 percent of all medication orders for pediatric inpatients. One of the only comprehensive studies of pediatric chemotherapy errors found that 13 percent of such errors reached children and 2 percent were serious and required intervention.
Dr. Marlene Miller of Johns Hopkins University and colleagues conducted a comprehensive review of a nationwide medication error database of inpatient facilities and outpatient clinics to characterize the patterns of errors and their causes for children receiving chemotherapy. Between 1999 and 2004, 829,492 errors were reported, of which 29,802 involved patients under 18 years old and 310 of these involved a chemotherapeutic drug.
The authors of the study found that 85 percent of these errors reached the patients. Sixteen percent were serious enough to require escalation of care, of which five patients required treatment or longer hospitalization. Of the 387 chemotherapeutic agents reported, the ones most commonly associated
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