CUTANEOUS ADVERSE DRUG REACTIONS TO SYSTEMIC THERAPY: PATTERNS, CAUSALITY, AND PREVENTABILITY IN 138 PATIENTS FROM A TERTIARY HOSPITAL IN WESTERN INDIA
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Abstract
Background: Cutaneous Adverse Drug Reactions is a frequent cause of dermatology consultations, the patient presentation can range from mild eruptions to severe life threatening reactions such as Stevens-Johnson syndrome(SJS) and Toxic Epidermal Necrolysis(TEN). Therefore, continous monitoring of CADRs is important to improve patient safety.
Objective: To evaluate the patterns, causality, severity and preventability of CADRs in patients presenting to a Tertiary care Hospital in Western India.
Methods: An observational cross-sectional study was conducted over 18months (July 2019 - January 2021) among 138 patients with mucocutaneous ADRs. Causality was assessed using WHO-UMC scale, severity with the Modified Hartwig and Siegel scale, and preventability with the Schumock and Thornton scale. Data were analysed descriptively.
Results: The most common CADR was Fixed Drug eruption(30.43%), followed by urticaria(28.26%). Antibiotics and NSAIDs were the most frequently implicated drug groups. Most reactions were of moderate severity(92.02%). Twenty cases were classified as definitely preventable, and one as probably preventable. One mortality was reported in a case of SJS-TEN secondary to Levetiracetam.
Conclusion: CADRs are common and often associated with irrational drug use, particularly antibiotics and NSAIDs. Most reactions were preventable or of moderate severity, highlighting the need for enhanced pharmacovigilance, patient education, and rational prescribing to reduce CADR-related morbidity and mortality.
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Dr Ankush Anil Ajbani
MD, Assistant Professor, GMERS Medical College, Gotri, Vadodara
Dr Nipul Vara
MD, Associate Professor, Dept of Dermatology, Medical College Baroda, Vadodara
Dr Hiral Shah
MD, Associate Professor, Medical college Baroda, Vadodara
Trivedi Rudra Pankajkumar
MBBS, GMERS Medical College, Gotri, Vadodara