Antibiotic Utilization Patterns and Adverse Drug Events Risk in Special Populations: A Comprehensive Review

Antimicrobials are among the most frequently prescribed drug classes globally, but their misuse contributes significantly to antimicrobial resistance (AMR) and a high burden of adverse drug events (ADEs). Special populations including pediatric, geriatric and critically ill patients face unique risks due to altered pharmacokinetics and higher rates of polypharmacy. Research indicates that approximately 20% of hospitalized adults receiving systemic antibiotics experience at least one ADE, with geriatric patients accounting for nearly 45.6% of these cases. In pediatric populations, antibiotics are responsible for nearly half of all drug-related emergency department visits. Drug utilization evaluations show a high prevalence of "Watch" group antibiotic use (Eg; Cephalosporins and Fluoroquinolones), which are frequently associated with serious side effects like skin rashes, gastrointestinal distress and nephrotoxicity. This review synthesizes current data on antibiotic consumption patterns using the WHO AWaRe framework and examines the severity and preventability of associated ADEs. The findings underscore the critical need for robust antimicrobial stewardship (AMS) and active Pharmacovigilance to mitigate risks in vulnerable cohorts and ensure patient safety