CURRENT TRENDS OF CUTANEOUS ADVERSE DRUG REACTIONS IN A TERTIARY CARE HOSPITAL IN NORTH INDIA: A RETROSPECTIVE STUDY

Authors

  • TEJINDER KAUR Department of Dermatology, Venereology and Leprosy, Government Medical College, Amritsar, Punjab, India
  • NIKITA MARGAM Department of Dermatology, Venereology and Leprosy, Government Medical College, Amritsar, Punjab, India
  • GURPREET KAUR RANDHAWA Department of Pharmacology, Government Medical College, Amritsar, Punjab, India

DOI:

https://doi.org/10.22159/ajpcr.2024v17i8.51076

Keywords:

Cutaneous adverse drug reactions, CADR to vaccines, CADR to antifungal

Abstract

Objectives: The objectives of this study were as follows: (1) To analyze the reported cutaneous ADRs in a tertiary care hospital for their pattern and suspected medications. (2) To assess the causality and severity of the CADR.

Methods: A retrospective study of cutaneous adverse drug reactions (CADRs) reported from July 2020 to August 2023 was conducted. The modified Hartwig and Siegel scale was utilized to evaluate the severity of the reactions, and Naranjo’s causality evaluation scale was employed to determine causality.

Results: A total of 187 cases were reported. Maximum cases (48.12%) were between 21 and 40 years age group. The most prevalent CADR pattern was maculopapular rash (57.21%) followed by fixed drug eruption (24.06%). The most common offending drug was diclofenac (9.90%) followed by paracetamol (7.2%). Overall, antimicrobial medicines accounted for the greatest number of CADRs (24.59%).

Conclusion: There was a broad range of clinical manifestations of CADRs, from maculopapular rash to severe Steven–Johnson syndrome. Overzealous use of the drugs should be avoided, and proper ADR monitoring should be done for patient safety.

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References

Al-Raaie F, Banodkar DD. Epidemiological study of cutaneous adverse drug reactions in Oman. Oman Med J. 2008;23(1):21-7. PMID 22567204

Amrinder R, Kaur I, Singh J, Kaur T. Monitoring of cutaneous adverse drug reactions in a tertiary care hospital. J Pharmacovigilance. 2016;4:207.

Badar V, Parulekar VV, Garate P. A surveillance study of cutaneous adverse drug reactions in a tertiary care teaching hospital in India. Int J Basic Clin Pharmacol. 2018 Dec;7(12):2439. doi: 10.18203/2319- 2003.ijbcp20184862

Bhanushali SP, Phulari YJ, Hiremath RN, Kandpal R, Patel P. A clinical-etiological study of adverse cutaneous drug reactions at tertiary care center in south India. Asian J Pharm Clin Res. 2022;15(4):71-6.

Bigby M, Jick S, Jick H, Arndt K. Drug-induced cutaneous reactions. A report from the Boston Collaborative Drug Surveillance Program on 15,438 consecutive inpatients, 1975 to 1982. JAMA. 1986;256(24):3358-63. doi: 10.1001/jama.256.24.3358, PMID 2946876

Brar BK, Kaur J, Kumar S, Sethi N, Kumar R. Cutaneous adverse drug reactions profile in a tertiary care hospital in North India. J Pak Assoc Dermatol. 2017;27(2):158-63.

Dhar S, Banerjee R, Malakar R. Cutaneous drug reactions in children. Indian J Paediatr Dermatol. 2014;15(1):5-11. doi: 10.4103/2319- 7250.131827

Ma L, Du X, Dong Y, Peng L, Han X, Lyu J, et al. First case of Stevens- Johnson syndrome after rabies vaccination. Br J Clin Pharmacol. 2018 Apr;84(4):803-5. doi: 10.1111/bcp.13512, PMID 29333656

Mahatme N, Narasimharao R. A study of clinical patterns and causative agents of adverse cutaneous drug reactions. Indian J Drugs Dermatol. 2016 Jan 1;2(1):13. doi: 10.4103/2455-3972.184088

Manjhi PK, Mohan L, Dikshit H, Mishra H, Kumar M, Shambhu D. Drug utilization pattern in dermatology outpatient department at a tertiary care hospital in Navi, Mumbai. Int J Basic Clin Pharmacol. 2017;6(3):559-62.

Mokhtari F, Nikyar Z, Naeini BA, Esfahani AA, Rahmani S. Adverse cutaneous drug reactions: Eight year assessment in hospitalized patients. J Res Med Sci. 2014;19(8):720-5. PMID 25422656

Nagaraju N, Puneetha B. The current trend of cutaneous drug reactions at a tertiary care hospital. Int J Res Dermatol. 2019;5(2): 2455-4529. doi: 10.18203/issn.2455-4529.IntJResDermatol20191086

Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239-45. doi: 10.1038/clpt.1981.154, PMID 7249508

Nayak S, Acharjya B. Adverse cutaneous drug reaction. Indian J Dermatol. 2008;53(1):2-8. doi: 10.4103/0019-5154.39732, PMID 19967009

Noel MV, Sushma M, Guido S. Cutaneous adverse drug reactions in a hospitalised patients in a tertiary care center. Indian J Pharmacol. 2004;36:292-5.

Panja B, Mukherjee S, Goswami D, Bhushan B, Bhattacharjee S, Sen S. Study of clinicodemographic profile of adverse cutaneous drug reactions in Indian perspective. APJHS 2022;9(4):98-106. doi: 10.21276/apjhs.2022.9.4S1.16

Patel TK, Barvaliya MJ, Sharma D, Tripathi C. A systematic review of the drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Indian population. Indian J Dermatol Venereol Leprol. 2013;79(3):389-98. doi: 10.4103/0378-6323.110749, PMID 23619444

Puavilai S, Timpatanapong P. Prospective study of cutaneous drugreactions. J Med Assoc Thai. 1989;72(3):167-71. PMID 2525591

Pudukadan D, Thappa DM. Adverse cutaneous drug reactions: Clinical pattern and causative agents in a tertiary care center in South India. Indian J Dermatol Venereol Leprol. 2004;70(1):20-4. PMID 17642552

Qayoom S, Bisati S, Manzoor S, Sameem F, Khan K. Adverse cutaneous drug reactions - a clinic-demographic study in a tertiary care teaching hospital of the Kashmir Valley, India. Arch Iran Med. 2015;18(4):228-33. PMID 25841943

Rana S, Gupta K, Agarwal N, Ahamed AN. A study of cutaneous adverse drug reactions and their association with autoimmune diseases at a tertiary centre in South-West Rajasthan, India. Indian J Dermatol. 2021 Jul;66(4):445. doi: 10.4103/ijd.IJD_261_17, PMID 34759420

Rath B, Naik MR, Rath B, Bhoi R, Prakash J. Cutaneous adverse drug reactions in a tertiary care hospital: An observational study. J Pharmacovigil Drug Res. 2020 Sep 1;1(1):6-9. doi: 10.53411/ jpadr.2020.1.1.2

Sacerdoti G, Vozza A, Ruocco V. Identifying skin reactions to drugs. Int J Dermatol. 1993;32(7):469-79. doi: 10.1111/j.1365-4362.1993. tb02829.x, PMID 8340180

Sharma R, Dogra D, Dogra N. A study of cutaneous adverse drug reactions at a tertiary center in Jammu, India. Indian Dermatol Online J. 2015;6(3):168-71. doi: 10.4103/2229-5178.156384, PMID 26009710

Washrawirul C, Triwatcharikorn J, Phannajit J, Ullman M, Susantitaphong P, Rerknimitr P. Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID‐19 vaccination: A systematic review and meta‐analysis. J Eur Acad Dermatol Venereol. 2022 Nov;36(11):1947-68. doi: 10.1111/jdv.18294, PMID 35666609

Published

07-08-2024

How to Cite

TEJINDER KAUR, NIKITA MARGAM, and GURPREET KAUR RANDHAWA. “CURRENT TRENDS OF CUTANEOUS ADVERSE DRUG REACTIONS IN A TERTIARY CARE HOSPITAL IN NORTH INDIA: A RETROSPECTIVE STUDY”. Asian Journal of Pharmaceutical and Clinical Research, vol. 17, no. 8, Aug. 2024, pp. 142-6, doi:10.22159/ajpcr.2024v17i8.51076.

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