Predictors of Adverse Drug Reactions to Reserve Antibiotics in Hospitalized Patients: A Tertiary Care Study

Comorbidity	Frequency (percentage)
Type 2 diabetes mellitus (yes/no)	50/106 (32.1%/67.9%)
Myocardial infarction (yes/no)	10/146 (6.4%/93.6%)
Heart failure (yes/no)	64/92 (41%/59%)
Peripheral vascular disease (yes/no)	22/134 (14.1%/85.9%)
Cerebrovascular disease (yes/no)	12/144 (7.7%/92.3%)
Dementia (yes/no)	10/146 (6.4%/93.6%)
Connective tissue disease (yes/no)	5/151 (3.2%/96.8%)
Chronic obstructive pulmonary disease (yes/no)	25/131 (16%/84%)
Peptic ulcer disease (yes/no)	29/127 (18.6%/81.4%)
Liver disease (yes/no)	5/151 (3.2%/96.8%)
Hemiplegia (yes/no)	14/142 (9%/91%)
Solid tumor (yes/no)	18/138 (11.5%/88.5%)
Chronic renal insufficiency (yes/no)	38/118 (24.4%/75.6%)
Leukemia (yes/no)	6/150 (3.8%/96.2%)
Lymphoma (yes/no)	2/154 (1.3%/98.7%)

Table 2.

Administered antibiotics (n = 156)

Antibiotic	Frequency (percentage)
Meropenem (aayes/no)	71/85 (45.5%/54.5%)
Imipenem/cilastatin (yes/no)	22/134 (14.1%/85.9%)
Piperacillin/tazobactam (yes/no)	12/144 (7.7%/92.3%)
Vancomycin (yes/no)	82/74 (52.6%/47.4%)
Teicoplanin (yes/no)	17/139 (10.9%/89.1%)
Linezolid (yes/no)	9/147 (5.8%/94.2%)
Colistimethate sodium (yes/no)	26/130 (16.7%/83.3%)
Tigecycline (yes/no)	20/136 (12.8%/87.2%)

Table 3.

Mean laboratory values (n = 156)

Laboratory parameter	Mean ± SD, median, IQR	Units
Platelets	277.69 ±161, 263.5, 212	×10⁹/L
Urea	10.6 ± 10.8, 7.55, 7	mmol/L
Serum creatinine	145.71 ± 173.68, 79, 80	μmol/L
Leukocytes	13.78 ± 17.99, 11.2, 8.3	×10⁹/L
Neutrophils	9.09 ± 7.72, 7.94, 6.2	×10⁹/L
ALT	65.68 ± 143.5, 22, 29	U/L
AST	76.68 ± 207.4, 27, 30	U/L
GGT	95.24 ± 121.2, 47.5, 98	U/L
Total bilirubin	25.9 ± 51.9, 13.45, 10	μmol/L
Direct bilirubin	12.84 ± 35.2, 4.1, 4.8	μmol/L
Amylase	73.15 ± 84.95, 56, 64	U/L
Lipase	103.13 ± 290, 8, 42	U/L
CRP	133.65 ± 92.83, 125, 140	mg/L

[i] Abbreviations: CRP – C-reactive protein; ALT – alanine aminotransferase; AST – aspartate aminotransferase; GGT – gamma-glutamyl transferase; SD – standard deviation; IQR – interquartile range.

Table 4.

Other relevant characteristics of the study population (n = 156)

Parameter	Frequency (percentage) for categorical variables, Mean ± SD, median, IQR for continuous variables
Adverse drug reaction (yes/no)	52/104 (33.3%/66.7%)
Recovery (yes/no)	33/123 (21.2%/78.8%)
Death (yes/no)	47/109 (30.1%/69.9%)
Prolonged hospitalization (yes/no)	11/145 (7.1%/92.9%)
Allergy history (yes/no)	21/135 (13.5%/86.5%)
ICU stay (yes/no)	74/82 (47.4%/52.6%)
Age	64.12 ± 13.75, 65.5, 17
Duration of ADR	2.81 ± 5.52, 0, 4
Charlson comorbidity index	4.5 ± 2.36, 4, 3
Duration of antibiotic therapy	9.68 ± 5.83, 9, 6
Length of hospitalization	36.58 ± 36.59, 29, 27
Total consultations	17.27 ± 17.24, 11, 15
Pharmacologist consultations	4.93 ± 3.99, 4, 5

[i] Abbreviations: SD – standard deviation; IQR – interquartile range. ICU-Intensive Care Unit

Table 5.

Characteristics of study participants according to the outcome – occurrence of ADRs.

Parameter	Cases (n=52) Frequency (%), median, [IQR]	Controls (n=104) Frequency (%), median, [IQR]	p-value
Sex (M/F)	33/19 (63.5%/36.5%)	65/39 (62.5%/37.5%)	0.907
Acute myocardial infarction	4/48(7.7%/92.3%)	6/98(5.8%/94.2%)	0.644
Heart failure	15/37(28.8/71.2%)	49/55(47.1%/52.9%)	0.029
Peripheral vascular disease	8/44(15.4%/84.6%)	14/90(13.5%/86.5%)	0.745
Cerebrovascular stroke	2/50(3.8%/96.2%)	10/94(9.6%/90.4%)	0.202
Dementia	3/49(5.8%/94.2%)	7/97(6.7%/93.3%)	0.817
Connective tissue disease	1/51(1.9%/98.1%)	4/100(3.8%/96.2%)	0.520
Peptic ulcer disease	5/47(9.6%/90.4%)	24/80(23.1%/76.9%)	0.042
Chronic obstructive pulmonary disease	7/45(13.5%/86.5%)	18/86(17.3%/82.7%)	0.537
Liver disease	3/49(5.8%/94.2%)	2/102(1.9%/98.1%)	0.199
Diabetes mellitus	16/36(30.8%/69.2)	34/70(32.7%/67.3%)	0.808
Hemiplegia	5/47(9.6%/90.4%)	9/95(8.7%/91.3%)	0.843
Chronic renal insufficiency	18/34(34.6%/65.4)	20/84(19.2%/80.8%)	0.035
Solid tumor	5/47(9.6%/90.4%)	13/91(12.5%/87.5%)	0.595
Leukemia	0/52(0%/100%)	6/98(5.8%/94.2%)	0.077
Lymphoma	0/52(0%/100%)	2/102(1.9%/98.1%)	0.314
Allergy	4/48(7.7%/92.3%)	17/87(16.3%/83.7%)	0.135
Meropenem	23/29(44.2%/55.8)	48/56(46.2%/53.8%)	0.820
Imipenem	8/44(15.4%/84.6%)	14/90(13.5%/86.5%)	0.745
Piperacillin/tazobactam	5/47(9.6%/90.4%)	7/97(6.7%/93.3%)	0.524
Vancomycin	24/28(46.2%/53.8)	58/46(55.8%/44.2%)	0.257
Teicoplanin	3/49(5.8%/94.2%)	14/90(13.5%/86.5%)	0.146
Linezolid	2/50(3.8%/96.2%)	7/97(6.7%/93.3%)	0.466
Colistin	10/42(19.2%/80.8)	16/88(15.4%/84.6%)	0.543
Tigecycline	7/45(13.5%/86.5%)	13/91(12.5%/87.5%)	0.866
ICU stay	27/25(51.9%/48.1)	47/57(45.2%/54.8%)	0.427
Recovery	33/19(63.5%/36.5)	0/104(0%/100%)	0.000
Death	15/37(28.8%/71.2)	32/72(30.8%/69.2%)	0.805
Prolonged hospitalization	11/41(21.2%/78.8)	0/104(0%/100%)	0.000
Age	64.5[16]	67.1[19]	0.507
Duration of ADR	7[8]	0[0]	0.000
Charlson comorbidity index	4[3]	4.5[3]	0.436
Duration of antibiotic therapy	6.5[8]	10[5]	0.005
Length of hospitalization	30[26]	28.5[26]	0.801
Total consultations	12[14]	11[16]	0.509
Pharmacologist consultations	4[6]	4[4]	0.722
AST	30[29]	26[31]	0.719
ALT	22[30]	21.5[30]	0.328
GGT	50.5[116]	40.5[97]	0.594
Total bilirubin	12[9.7]	13.9[11.1]	0.293
Direct bilirubin	3.55[4.1]	4.1[4.9]	0.344
Amylase	61.5[47]	49[62]	0.250
Urea	7.75[7.7]	7.4[7]	0.870
Creatinine	86.5[135.8]	77[65]	0.307
Leukocytes	9.5[6.5]	11.7[9.3]	0.037
Neutrophils	6.8[4.8]	8.52[6.64]	0.068
Platelets	256[166]	267[241]	0.936
CRP	133.3[149.5]	120.4[116.1]	0.897

[i] Abbreviations: CRP – C-reactive protein; ALT – alanine aminotransferase; AST – aspartate aminotransferase; GGT – gamma-glutamyl transferase; ICU-Intensive Care Unit; IQR – interquartile range.

Table 6.

Statistically significant predictors of ADR occurrence identified by multivariate logistic regression

Risk factor	Crude OR (95% CI)	Adjusted OR (95% CI)	P value
Heart failure	0.455 (0.223–0.928)	0.262 (0.115–0.599)	0.002
Peptic ulcer disease	0.355 (0.127–0.992)	0.268 (0.091–0.790)	0.017
Chronic renal insufficiency	2.224 (1.049–4.713)	3.356 (1.415–7.955)	0.006

[i] Abbreviations: OR – odds ratio; CI – confidence interval; p – probability of the null hypothesis.

References

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Articles in this issue

DOI: https://doi.org/10.2478/eabr-2026-0014 | Journal eISSN: 2956-2090 (formerly 2335-075X, 2956-0454) | Journal ISSN: 2956-0454 (formerly 1820-8665)

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Language: English

Page range: 179 - 186

Submitted on: Mar 10, 2026

Accepted on: Mar 27, 2026

Published on: Oct 24, 2026

Published by: University of Kragujevac, Faculty of Medical Sciences

In partnership with: Paradigm Publishing Services

Keywords:

Adverse drug reactions,

reserve antibiotics,

hospitalized patients,

UDC:

Related subjects:

Clinical medicine, other

© 2026 Nemanja Z. Petrovic, Mirjana Milojevic Corbic, Slobodan M. Jankovic, published by University of Kragujevac, Faculty of Medical Sciences
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Volume 27 (2026): Issue 2 (June 2026)