Cutaneous Reactions to Drugs in Children

Adverse drug reactions (ADR) are an important medical problem. The aim of this study is to investigate the clinical characteristics of children with ADR and to assess the tolerability of alternative drugs in children (under 16 yrs of age) with a history of ADR. We studied 278 children (132 males and 146 females). Patients were studied by recording personal history and performing in vivo skin testing, in vitro laboratory tests and challenge tests. Patients who had experienced mild adverse reactions underwent challenge tests without any premedication; patients with a clinical history of moderate reactions, received a premedication with sodium cromolyn 30 min before the oral challenge; patients with a clinical history of severe reactions or undergoing parenteral challenges, were given an antihistamine 30 minutes before. A total of 660 adverse events were reported with 126 different drugs involved. Antimicrobial agents were the most involved drugs (51.7%). Non-steroidal anti-inflammatory drugs were involved in 22.7% of episodes. The most reported symptoms were cutaneous. Allergy testing was negative in 272 patients. A diagnosis of drug allergy was reported for 6 patients. A total of 669 challenge tests were performed. 639 were negative at first attempt while 22 were positive. Eight were repeated using a different premedication and resulted negative. Hypersensitivity drug reactions in children are mainly non-allergic. A premedication with sodium cromolyn or with oral HI-antihistamines may be useful in preventing ADR.All drugs, even if properly used, may be responsible for unwanted effects, which represent a matter of concern for the patient and a challenge for the attending physician. The majority (about threequarters) of these events are due to the chemical and pharmacological properties of the drugs themselves and so they are usually predictable and avoidable; they include side effects, drug interactions and overdosing.Unexpected adverse drug reactions, which are not related to the mechanism of action of drugs, may also occur; these include idiosyncrasy and hypersensitivity reactions (1-4). Adverse drug reactions (ADR) are a frequent cause of hospital admission (3 to 8%) and the incidence among the US hospitalized patients is 15.1% (1).Prevalence may vary in the pediatric population, depending on the groups of patients and the methods

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“…Cutaneous symptoms such as urticaria and/or angioedema are prevalent, as already observed in literature (22)(23) .…”

Section: Discussionsupporting

confidence: 58%

Allergic and Non-Allergic Drug Hypersensitivity Reactions in Children

Buonomo

Altomonte

et al. 2010

Int J Immunopathol Pharmacol

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“…7 Cutaneous drug reactions are the commonly reported type of ADR. 8 Although such cutaneous reactions are common, information regarding their incidence, severity and ultimate health effects are often not available as many go unreported. Cutaneous drug reactions patterns and the drugs causing various reactions are changing every year, which may be due to the emergence of newer molecules and changing trends in the use of drugs.…”

Section: Introductionmentioning

confidence: 99%

Cutaneous drug reactions notified by ADR monitoring centre in a tertiary care hospital of Bihar

Manjhi

Mohan

Dikshit

et al. 2016

Int J Basic Clin Pharmacol

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Background: Cutaneous drug reactions are most frequent drug related adverse events which lead to early treatment discontinuations, high treatment cost and leading cause of morbidity and mortality. The aim of this study is to analyze the clinical patterns and offending drugs as well as their causality, severity and preventive strategies.Methods: All adverse drug reactions (ADRs) forms filled from May 2015 to April 2016 were scrutinized and forms with cutaneous drug reactions were analyzed and assessed for causality, severity and preventability.Results: Out of 300 ADR forms, 160 (53.34%) included cutaneous drug reactions. 68 (42.50%) patients were male and 92 (57.50%) were female. Maculopapular rash 58 (36.25%), fixed drug eruption (FDE) 31 (19.37), pruritus 27 (16.87%) and urticaria 19 (11.87%) were the common clinical patterns of cutaneous drug reactions. Most common offending drug classes included antibiotics, anti-inflammatory and steroidal agents. Causality assessment was done by using Naranjo’s algorithm. The result showed that out of 160 cutaneous drug reactions 141 (88.12%) ADRs were probable, 15 (9.37%) were classified as possible; 2 (1.25) doubtful and 2 (1.25%) were definitely related to the drug.Conclusions: The present study shows cutaneous drug reactions are commonly reported at ADR monitoring centre of this tertiary care hospital. Our study suggests that there is a need of intensive monitoring for ADRs in tertiary care hospital for early detection and to ensure the patient safety.

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“…SJS and TEN can occur within 3 months of drug intake, although the highest risk appears to be during the first 3 or 4 weeks. 17,18 Other risk factors for developing SJS include age (less common in children <15 years than in adults), HIV status (more common in HIV-positive than in HIV-negative individuals) 19,20 and genetic factors. 17 In southern Tanzania, an operational research programme developed and implemented a programme to evaluate the effectiveness and safety of IPTi-SP in an area with a total population of approximately 900 000 people.…”

Section: Introductionmentioning

confidence: 99%