Early Event Detection and Discontinuation of the Culprit Drug Increases the Rate of Survival in Severe Cutaneous Adverse Drug Reactions: A Multi-Center Study in Bangladesh

Abstract

Adverse drug reactions are completely unwanted drug reactions derived from self-medications and among those unpleasant reactions, severe cutaneous adverse drug reactions like, Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, Acute Generalized Exanthematous Pustolosis and Drug Reaction with Eosinophilia and Systemic Symptoms, are mostly life threatening harms, globally. The main objective of this study was to find out the impact of early detection of the adverse drug events and consequently prompt withdrawn of the suspected culprit drugs in the ultimate survival rate among the patients experienced with these types of unwelcome life threatening events in Bangladesh. Here, we found that antibiotics were accounted for most adverse drug reactions (81.13%, n=53) including serious reactions. This study also showed that if the adverse drug event is possibly detected with in the first 48 hours then, 72.73% (n=11) patients were survived from severe cutaneous adverse drug reactions, where as if delayed than 48 hours, only 20% (n=5) patients were survived. Similarly, 77.77% (n=9) patients were survived after the proper treatment when suspected culprit drugs were discontinued within first 48 hours and late discontinuation resulted in only 28.57% (n=7) survival rate among these patients. So, prompt response through early event-detection and discontinuation of the culprit drug, to a serious cutaneous adverse drug reaction can tremendously save life by providing early necessary management and required treatment.

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“…In almost all the papers, ABs were one of the major causes of cADRs or ScADRs. The lowest frequency was found to be between 5% -10% [15,26,42] and highest being 81.13% [70] followed by 73.8% [71]. Several other studies also found a very high frequency of AB-associated cADRs like- Wong et al, (2019) [72] 66.1%, Dimri, Raina, Thapliyal, & Thawani, (2016) >69% [11], and Verma et al, 56% [73] (Table 2).…”

Cutaneous Adverse Drug Reactions to Antibiotics: How Much is the Extent of the Problem?

“…In almost all the papers, ABs were one of the major causes of cADRs or ScADRs. The lowest frequency was found to be between 5% -10% [15,26,42] and highest being 81.13% [70] followed by 73.8% [71]. Several other studies also found a very high frequency of AB-associated cADRs like- Wong et al, (2019) [72] 66.1%, Dimri, Raina, Thapliyal, & Thawani, (2016) >69% [11], and Verma et al, 56% [73] (Table 2).…”