Cutaneous Adverse Drug reactions: A Four-Year Study from Western Nepal

Abstract

Background: Cutaneous adverse drug reactions (CADRs) range from minor reactions to several life threatening complications. Objectives: To study the clinical spectrum of cutaneous adverse drug reactions, determine the causative drugs responsible for the reactions and to assess the preventability.Methods: The study was carried out in the Department of Dermatology of Gandaki Medical College Teaching Hospital from June 2011 to June 2015. All the patients attending the Dermatology Outpatient Department and the patients admitted in the wards with suspected cutaneous adverse drug reactions to systemic drugs were included in the study. A detailed clinical history, including the history of drug intake was noted. Each case was assessed for its causality by using the WHO definitions. Data analysis was done using SPSS software.Results: There were 102 patients in total. The mean age of the patient was 32 ±15.7 years. Maximum patients belonged to the 21 to 30 years age group. There were 59 female patients and 43 male patients. Severe type of cutaneous adverse drug reactions was noted in 7.8% of patients. Antibiotics were responsible for most of the cutaneous adverse drug reactions. Cefixime was the most commonly incriminated drug. Exanthematous drug reaction was the most common type seen in 45%. Stevens-Johnson syndrome was the commonest type noted among the serious adverse drug reactions. Drug preventability was noted in 6% of patients.Conclusions: The commonest type of CADR noted was exanthematous type. Antibiotics were the commonest drug group involved in CADR. Six percent of CADR were preventable. J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 21-26

Studi retrospektif erupsi obat alergik di RS dr. M. Djamil Padang periode Januari 2014 – Desember 2016

“…Karbamazepin merupakan golongan anti-konvulsan yang biasa dipakai pada penyakit-penyakit seperti epilepsi, neuralgia trigeminal, neuralgia diabetes mellitus, neuralgia glosofaringeal, dan neuralgia post herpetik. 4 Pada penelitian ini, seluruh pasien kami mendapatkan karbamazepin untuk gangguan psikosomatis.…”

Polypharmacy as a Risk Factor for Exanthematous Drug Eruption

“…Research conducted by Jha N et al showed similar results with cephalosporins at 22.73% and carbapenems at 17.27% [3]. Several cephalosporin drugs were found to trigger cutaneous adverse drug reactions, including ceftriaxone, cefixime, and cefotaxime [14,16,17].…”

“…Cutaneous adverse drug reactions are usually caused by antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), and anticonvulsants [3,5,11]. The cause that is often found as a trigger for the exanthematous drug eruption is antibiotics [13,14,15]. Classes of antibiotics that often cause this condition are β-lactam such as penicillins, cephalosporins, and carbapenems [3,13,15].…”

Prevalence and Causality Assessment of Cutaneous Adverse Drugreactions.

“…The second common CADR was seen is Fixed drug eruption (FDE) with about (13.3%) followed by Erythematous rash that showed (11.1%), Toxic Epidermal Necrolysis (TEN) and Urticaria recording (7.5%).in which 1 was fatal with TEN wherein similar mortality with TEN was seen in the study of Saraswoti neupane and Surya Raj Sharma (2012) 12 Steven Johnson Syndrome (SJS) were identified in (4.4% 23 The results of assessment of the severity index revealed most cases with Moderate about (62.2%), followed by Mild about (26.6%). (10%) were identified as Severe .One case (1.1%) was fatal which was similarly seen in the study by Saraswoti neupane and Surya Raj Sharma (2012) 12 In our study all the cases were Type B (Bizarre type) which was similarly seen in the study by Karamsad Suthar J. and Desai S.V (2011) 19 where 100% ACDRs were Type B (Bizarre immunological allergic drug reaction).…”