Severe Cutaneous Adverse Drug Reactions in Bangladesh: A Review in a Tertiary Level Hospital

Abstract

Introduction: The Severe Cutaneous Adverse Drug Reactions (SCADRs) are rare but life-threatening as these encompass drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and acute generalized exanthematous pustulosis (AGEP).
 Objective: To estimate the incidence of SCADRs and to find out the cause in Bangladesh.
 Materials and Methods: 50 patients with SCADRs were studied over a period of 1 year from January 2015 to December 2015 in the Department of Dermatology, Combined Military Hospital, Dhaka. Data were collected from the informant and recorded in structured Case Report Form. Quantitative data were expressed as mean and standard deviation and qualitative data as frequency and percentage.
 Results: Clinical diagnosis of the study subjects recognized 46.0% cases as SJS, 28(19.0%) as TEN, 16.0% as DRESS and 10.0% as AGEP. The maximum incidence (46%) was seen in the age group of 31-50 years; mean age of the patient was 37.42+5.3 years. Male and female ratio was 2.84:1. Anticonvulsant group of drugs could give rise to maximum incidence of SCADRs. Carbamazepine was responsible in 22.0% cases of SCADRs, followed by Phenytoin in 16.0% patients and Phenobarbital in 14.0% cases.
 Conclusion: SCADRs were seen mostly with the anticonvulsant drugs belonging to Carbamazepine and Phenytoin group. SCADRs deserve continuous monitoring to plan preventive strategies.
 Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 71-75

Early Event Detection and Discontinuation of the Culprit Drug Increases the Rate of Survival in Severe Cutaneous Adverse Drug Reactions: A Multi-Center Study in Bangladesh

“…On the other hand, only 2 (28.57%, n=7) (5 victims died) victims were survived when discontinuation of the culprit drug was done after the first 48 hours of the event-detection (Table 3). (Chowdhury et al 2016). An one year long study in Bangladesh showed that among the SCADRs during that time, 46% cases are SJS, 28% cases are TEN, 16% cases are DRESS and 10% cases are AGEP recorded (Chowdhury et al 2016).…”

“…(Chowdhury et al 2016). An one year long study in Bangladesh showed that among the SCADRs during that time, 46% cases are SJS, 28% cases are TEN, 16% cases are DRESS and 10% cases are AGEP recorded (Chowdhury et al 2016).…”

“…ADR can also be defined as a noxious, unpleasant or unwanted reaction resulting from a medicinal intervention at a regular dose used in human in order to prophylaxis, diagnosis or therapy (Aronson et al 2005;World health organization, 2003). ADRs are the fourth among the six leading causes of death in USA and 6.9% of total admitted patients in Indian hospitals are due to ADRs (Chowdhury et al 2016). ADRs can be broadly classified into two groups-type A (predictable reactions, usually dose-dependent) and type B (unpredictable or idiosyncratic, and not dosedependent).…”