Epidemiology of adverse cutaneous drug reactions.: A prospective study in hospitalized patients
Epidemiology of adverse cutaneous drug reactions.: A prospective study in hospitalized patients
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DOI：
10.1016/j.arcmed.2006.03.010
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发表时间：
2006-10-01
影响因子：
7.7
通讯作者：
Orozco-Topete, Rocio
中科院分区：
文献类型：
--
作者：
Hernandez-Salazar, Amparo;Ponce-de-Leon Rosales, Samuel;Orozco-Topete, Rocio
背景药物反应通常存在于皮肤中;然而，其在我们的环境中的频率是未知的。设计了一项为期10个月的前瞻性队列研究，包括所有住院患者。对发生皮肤药物不良反应（ACDR）的患者进行临床鉴定。在4785例（2713例女性，2072例男性）出院患者中观察到35例药物反应（患病率为0.7%）。根据Begaud的可归责性标准，4.87%、41.46%和53.65%的反应最可能归因于药物。最常见的皮肤病为麻疹样疹51.2%，荨麻疹12.2%，多形性红斑4.9%。最常与ACDR相关的药物是阿莫西林克拉维酸（8）、阿替西霉素B（2）和安乃近（4）。表示为1000天剂量的风险（Dd：患者接受药物治疗1天后发生ACDR的风险）：阿莫西林克拉维汀Dd 7.7，阿替西他滨B Dd 4.8和安乃近Dd 3.7。免疫抑制患者最常受到影响。值得注意的是，系统性红斑狼疮（SLE）患者发生ACDR的风险高4.68（CI 95% 1.794-12.186 p < 0.001）。艾滋病患者的危险度为8.68（95%CI 2.18-33.19，P
Background. Drug reactions are commonly present in the skin; however, their frequency in our setting is unknown.Methods. A 10-month prospective cohort study including all hospitalized patients was designed. Those with adverse cutaneous drug reactions (ACDR) were clinically identified.Results. Thirty five drug reactions (prevalence of 0.7%) were seen among 4785 (2713 females, 2072 males) discharged patients. According to Begaud's imputability criteria, the reactions were most likely attributed to a drug in 4.87%, likely in 41.46% and possible in 53.65%. The most commonly seen dermatoses were morbilliform rash 51.2%, urticaria 12.2% and erythema multiforme 4.9%. Drugs most frequently associated with ACDR were amoxicillin clavulanate (8), amphotericin B (2) and metamizole (4). Expressed as risk by 1000 day-doses (Dd: the risk a patient has of developing an ACDR after receiving I day of treatment with the drug): amoxicillin clavulanate Dd 7.7, amphotericin B Dd 4.8 and metamizole Dd 3.7. Immunosuppressed patients were most frequently affected. Notably, patients with systemic lupus erythematosus (SLE) had a 4.68 higher risk (CI 95% 1.794-12.186 p < 0.001) of developing an ACDR. AIDS patients showed a risk of 8.68 (CI 95% 2.18-33.19 p