Severe cutaneous adverse drug reactions of Chinese inpatients: a meta-analysis

Deng, Qiancheng; Xia, Fang; Zeng, Qinghai; Lu, Jianyun; Jing, Chen; Huang, Jinhua

doi:10.1590/abd1806-4841.20175171

Cited by 19 publications

(14 citation statements)

References 15 publications

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“…[6][7][8][9] Regarding SCARs, the drugs involved depend on the population (adults or children). In this sense, antibiotics and anticonvulsants are the most common ones in adults 10 ; and antibiotics, NSAIDs, and chemotherapeutics 11 as well as aromatic anticonvulsants and also allopurinol are the most frequently involved in children. [12][13][14] Over the last years, DHRs to new drugs as monoclonal antibodies, sulphasalazine and antituberculosis drugs have also been reported.…”

Section: The Burden Of Drug Hyper S En S Itivit Ymentioning

confidence: 99%

Recent developments and highlights in drug hypersensitivity

Mayorga

Fernandez

Montañez

et al. 2019

Allergy

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Drug hypersensitivity reactions (DHRs) are nowadays the third cause of allergy after rhinitis and asthma with a significant increase in prevalence in both adults and paediatric population with new drugs included as culprit. For this, DHRs represent not only a health problem but also a significant financial burden for affected individuals and health systems. Mislabelling DHRs is showing to be a relevant problem for both, false label of drug allergic and false label of nonallergic. All this reinforces the need to improve accurate diagnostic approaches that allow an appropriate management.Moreover, there is a need for training both, nonallergist stakeholders and patients to improve the reaction identification and therefore decrease the mislabelling. The use of allergy cards has shown to be relevant to avoid the induction of DHRs due to the prescription of wrong medication.Recent developments over the last 2 years and highlights about risk factors, diagnostic approaches, mechanisms involved as well as prevention actions, and management have been reviewed. In these papers, it has been outlined the need for correct diagnosis and de-labelling of patients previously false-reported as allergic, which will improve the management and treatment of patients with DHRs. K E Y W O R D Sallergy diagnosis, allergy treatment, basic mechanisms, drug allergy, epidemiology | 2369

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Section: The Burden Of Drug Hyper S En S Itivit Ymentioning

confidence: 99%

Recent developments and highlights in drug hypersensitivity

Mayorga

Fernandez

Montañez

et al. 2019

Allergy

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“…10 SCADRs are in effect a group of delayed-type hypersensitiv- 13 In China, exfoliative dermatitis (ED) is also classified as an SCADR. 14 Studies have shown that SJS is the most frequent clinical subtype of SCADR in China. 14 The study of SCADRs based on litigation cases has not previously been reported, yet this type of research is crucial for improving knowledge of the general characteristics of SCADRs, their causes, associated economic burden and potential preventive measures.…”

Section: What Is K Nown and Objec Tivementioning

confidence: 99%

“…49 (20) c. Inadequate estimation of severity of SCADRs; delayed or missed diagnosis; and improper, non-standard or delayed treatment. 35 (14) Total 251 (100)…”

Section: What Is Ne W and Con Clus I Onmentioning

confidence: 99%

General characteristics, economic burden, causative drugs and medical errors associated with medical damage litigation involving severe cutaneous adverse drug reactions in China

Zheng

Jiang

et al. 2020

J Clin Pharm Ther

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What is known and objective To investigate the general characteristics, economic burden, causative drugs and medical errors associated with litigation involving severe cutaneous adverse drug reactions (SCADRs) in China, with the aims of improving rational medication use and reducing the extent of damage from SCADRs. Methods This study analysed 150 lawsuit judgements involving SCADRs from 2005 to 2019, collected from China Judgments Online. Results and discussion In total, 50% of lawsuits stemmed from SCADRs occurring in general hospitals. The average time elapsed from the date of occurrence of the SCADRs to the end of litigation procedures was 1055 days. Of the patients involved, 51% were female and more than two thirds (69%) were under 60 years old. The most common outcome of SCADRs was death (39%), followed by disabilities (30%). The average responsibility of the medical provider was 48 ± 29%. The average amount of compensation was $43 424. Of the cases studied, 51% of SCADRs were Stevens‐Johnson syndrome or toxic epidermal necrolysis, which together accounted for 75% of cases with known clinical subtype. The overall average economic burden of SCADRs was $99 178, of which indirect costs made up the largest proportion (more than 60%). The most common causative drug groups were antimicrobial drugs (49%), Chinese patent medicine and Chinese herbal medicine (17%), and antipyretic analgesics (16%). Finally, 61% of medical errors were found to stem from violation of duty of care, 20% from violation of informed consent and 18% from violations related to the medical record writing and management system. What is new and conclusion Severe cutaneous adverse drug reactions not only severely affect patient survival and quality of life, but also impose a heavy economic burden in terms of health care and societal costs. Medical providers should be better educated on strategies to reduce risk to patients and establish mechanisms of risk sharing and management.

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“…However, many skin diseases, it is essential to consider drugs as a possible cause of any eruption, because drug eruptions can take the form of any skin lesion. 11,12 Other than skin diseases and adverse drug reactions some systemic infections can cause skin rashes. 13 The pathophysiology of drug-induced adverse skin eruptions is not exactly known, however, immune-mediated reactions occur as a result of bizarre effects.…”

Section: Discussionmentioning

confidence: 99%

Amoxicillin induced erythematous maculopapular rashes: a case report

Kumar¹,

Rajganesh²,

Shree³

et al. 2020

Int J Basic Clin Pharmacol

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Cutaneous adverse reactions (CAR) can occur with any class of drugs, however more widely caused by various antibiotics. Amoxicillin is a broad-spectrum, bactericidal, beta-lactam antibiotic, widely used for combating various infections. Cutaneous drug eruptions are known to be reported common while using penicillin class of drugs, specifically among children. These immune-mediated bizarre drug eruptions were range from mild to severe drug-induced cutaneous reactions, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). The present case reported with maculopapular, erythematous rashes induced by amoxicillin in a nine-year-old male patient. Amoxicillin was prescribed for his hyperactive respiratory disease and subsequently after three days developed generalized maculopapular erythematous rashes as a result of an antibiotic-induced skin rash. The present case is being reported to add more data, also to emphasize and gather the information for evidence-based practice and to promote efficient pharmacovigilance adverse drug reaction reporting.

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Severe cutaneous adverse drug reactions of Chinese inpatients: a meta-analysis

Cited by 19 publications

References 15 publications

Recent developments and highlights in drug hypersensitivity

Recent developments and highlights in drug hypersensitivity

General characteristics, economic burden, causative drugs and medical errors associated with medical damage litigation involving severe cutaneous adverse drug reactions in China

Amoxicillin induced erythematous maculopapular rashes: a case report

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