Drug-induced hypersensitivity: A 5-year retrospective study in a hospital electronic health records database

Abstract

Summary What is known and Objective Hypersensitivity adverse drug reactions (HADRs) are associated with considerable morbidity and mortality. The aim of this study was to identify cases of HADRs within a hospital electronic health records (EHR) database. Methods Data were extracted from EHR through the Portuguese catalogue of allergies and other adverse reactions (CPARA). This registry allows the collection and sharing of information on HADRs in a structured and harmonized way across the healthcare system. This module is used by healthcare professionals to record HADRs within the EHR of each patient. It applies to patients admitted to hospital because of HADRs and also to inpatients developing such reactions during hospitalization. Data recorded from 2013 to 2017 within the Centro Hospitalar de Entre o Douro e Vouga (CHEDV) hospital (397 beds; ≈20 300 inpatients/year) were considered. The MedDRA® classification was used to codify HADRs. The ATC classification system was used to codify drugs. The concept of individual case safety report (ICSR) was considered for performing analyses. Results and discussion The database contained 464 valid cases (severe, n = 330; 71.1%), corresponding to 380 patients and 559 HADRs. Most patients were female (n = 254; 66.8%); the median age was 55 years. Approximately 0.1% local inhabitants and ≈0.4% inpatients have experienced HADRs over the study period. Most cases (n = 245; 52.8%) were associated with systemic antibacterials. Most HADRs were skin and subcutaneous tissue disorders (n = 266; 47.6%) and immune system disorders (n = 231; 41.3%). The pattern of suspected drugs implicated in anaphylactic reactions was the same as those involved in other HADRs. What is new and conclusion This registry contains HADRs that are relevant for the pharmacovigilance system, but none was spontaneously reported. The responsible authorities should address this problem. The results also reinforce the association between systemic antibacterials and HADRs.

Evaluation of the frequency and characteristics of drug hypersensitivity reactions in hospitalized children: Real life-cohort study

“…The prevalence of inpatient DHR was previously reported as 0.4–1.14% in studies including mostly adults. 3 , 22 , 23 , 24 , 25 We evaluated in-hospital DHRs among pediatric inpatients over 1 year and determined that 1.1% of all hospitalized patients were given allergy consultations for suspected DHRs. DHR could be confirmed in 25% (n = 48) of these reactions and could be ruled out in 34% (n = 66), either during hospitalization (24%) or after discharge (10%).…”

GenotypingHLAalleles to predict the development of Severe cutaneous adverse drug reactions (SCARs): state-of-the-art

“…DHRs represent a significant public health problem with a prevalence of 10-20% in hospitalized patients and up to 7% in the general population exposed to drugs [76]. Tang et al surveyed the diagnostic modalities used in the evaluation and management of DHRs among member countries of the Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI) which included respondents from five Southeast Asian countries [77].…”

Drug-induced hypersensitivity reactions in a Lebanese outpatient population: A decade-long retrospective analysis (2012-2021)

“…Furthermore, epidemiological data on DHRs in nonhospitalized patients are scarce and are limited mainly to antibiotics. 28 , 29 , 30 , 31 , 32 There are few publications on drug-allergic outpatients worldwide, and only a few of those previously published were located in the Middle East. 33 , 34 , 35 In addition, Lebanon’s geographical location and social characteristics have impacted the population’s genetic diversity, leading to the identification of numerous distinct genetic particularities.…”