Clinical profile of cutaneous adverse drug reactions: a retrospective study of 1883 hospitalized patients from 2007 to 2016 in Shanghai, China
Clinical profile of cutaneous adverse drug reactions: a retrospective study of 1883 hospitalized patients from 2007 to 2016 in Shanghai, China
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皮肤药物不良反应临床概况：2007年至2016年上海1883例住院患者的回顾性研究
DOI：
10.1684/ejd.2020.3713
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发表时间：
2020-01-01
影响因子：
2.5
通讯作者：
Luo, Xiaoqun
中科院分区：
文献类型：
--
作者：
Yang, Fanping;Chen, Zihua;Luo, Xiaoqun
皮肤药物不良反应（CADR）是药物引起的皮肤反应，有或没有全身受累，范围从轻度斑丘疹性皮炎（MPE）到危及生命的重度CADR（S-CADR）。由于其不可预测性和严重性，强烈建议早期识别可疑的致病药物。然而，CADR的概况在中国仍然未知。目的了解上海地区CADR的临床特征、主要致病药物及相关费用。资料与方法回顾性分析2007年1月至2016年12月华山医院皮肤科收治的CADR患者的临床资料。结果共调查1,883例CADR患者，其中女性1,231例，男性652例。S-CADR占所有病例的21.99%（n=414），荨麻疹（27.19%）是最常见的反应。多药药疹占53.43%，单药药疹占45.83%。总体而言，抗菌药物（28.85%）是涉及的主要药物组，对于S-CADR，这是抗癫痫药物（36.15%）。CADR的总成本为人民币23，718，788.83元（3，588，319.04美元）。年龄和性别均与住院费用相关（分别为p=0.005和p=7.84E（-8））。抗菌药物是导致CADR的最常见治疗方法。结论CADR的治疗需要相当的医疗费用。CADR不仅是一个健康问题，而且对受影响的个人来说也是一个重大的经济负担。
Background Cutaneous adverse drug reactions (CADRs) are drug-induced skin reactions with or without systemic involvement, ranging from mild maculopapular exanthema (MPE) to life-threatening severe CADRs (S-CADRs). Due to their unpredictability and severity, early recognition of suspected causative drugs is highly recommended. However, the profile of CADRs remains unknown in China. Objectives To assess the clinical profile, predominant causative drugs, and cost associated with CADRs in Shanghai, China. Materials and Methods Clinical records of inpatients admitted with a diagnosis of CADRs to the dermatology ward of Huashan Hospital from January 2007 to December 2016 were retrospectively studied. Results A total of 1,883 patients (1,231 female and 652 male), admitted with a diagnosis of CADR, were investigated. S-CADRs made up 21.99% of all cases (n=414), and urticaria (27.19%) was the most frequent reaction. Of the patients, 53.43% suffered from multiple drug-induced drug eruptions and the rest (45.83%) from single drug-induced drug eruptions. Overall, antimicrobials (28.85%) was the main drug group involved, and for S-CADRs, this was antiepileptic drugs (36.15%). The total cost for CADRs was RMB23,718,788.83 ($3,588,319.04). Both age and sex were related to admission cost (p=0.005 and p=7.84E(-8), respectively). Antimicrobials were the most common treatment causing CADRs. Conclusion The management of CADRs requires considerable medical cost. CADRs are not only a health problem but also a significant financial burden for affected individuals.