Cutaneous Adverse Drug Reactions:
A 6-Month Teaching Hospital Based
Study from Mid-Western Nepal
445-448
Correspondence
Dr. Saraswoti Neupane (MBBS, MD)
Department of Dermatology, Venereology and Leprology
Gandaki Medical College Teaching Hospital, Pokhara, Nepal.
E mail: sarunpn@yahoo.com
Background:
Cutaneous adverse drug reactions (CADRs) are a frequent problem in dermatology, but only a few prospective studies on these have been reported. This study was done to (i) evaluate the incidence of CADRs from systemic drugs; (ii) study the characteristics of the patients with CADRs; (iii) describe the CADRs; and (iv) evaluate the drug reaction imputability and preventability.
Materials and Methods:
This was a prospective, descriptive study which was conducted at the Department of Dermatology of Nepalgunj Medical College Teaching Hospital, Banke, Nepal. from May 2008 to October 2008. All the patients who attended the dermatology OPD and those patients who were admitted in the wards with suspected CADRs to systemic drugs were included in the study. Each case was assessed for its causality by using the WHO causality definitions. The data which was collected was subjected to descriptive analysis.
Results:
Out of 2904 dermatology patients, 1.6% had a diagnosis of CADRs. The ages of the patients ranged from 9-years to 52- years, with a mean of 30-years. The male to female ratio was 1.08. A majority of the patients had taken the drugs for underlying infections (56%). The major drug group which was implicated in the CADRs was antibiotics, followed by anti-convulsants. Among the antibiotics, Cotrimoxazole accounted for the highest number of CADRs, in 5 cases. Fixed drug eruption was the most common type of reaction which was observed (in 6 cases). As a whole, 28% of the CADRs were severe, that included exfoliative dermatitis, erythema multiforme, the Stevens-Johnson syndrome and toxic epidermal necrolysis. There was mortality in one case of toxic epidermal necrolysis.
Conclusion:
The commonest type of drug reaction which was noted was fixed drug eruption. Antibiotics were the most common drugs which caused the CADRs. Most of the drug reactions were caused by Cotrimoxazole.