Retrospective analysis of drug eruptions in 89 cases

Abstract

Objective To investigate the clinical features of drug eruptions and the most common causative drugs in inpatients in order to provide a reference for the diagnosis and the treatment of drug eruptions. Methods We retrospectively analyzed the clinical data of inpatients with drug eruptions at the First Affiliated Hospital of Shihezi University from April 2019 to December 2023. Results A total of 89 inpatients with drug eruptions, accounting for 2.90% of the total inpatients at the dermatology department during the same period, included 63 cases (70.79%) of mild drug eruptions (mainly the exanthematous eruptions) and 26 cases (29.21%) of severe drug eruptions (mainly SJS). The most common condition using allergenic drugs was infectious diseases (44 cases, 49.44%), while the majority of drug eruptions (63 cases, 70.79%) were caused by single drug. The top 3 allergenic drugs were antibiotics (33.33%), traditional Chinese medicine (26.98%) and antiepileptics (14.29%). The latency time of mild drug eruptions was shorter than that of severe drug eruptions (4.56±6.14 days vs. 9.35±11.33 days, t=2.03, P=0.025). High fever at the early stage was observed in 19.05% of patients with mild drug eruptions and 46.15% of patients with severe drug eruptions. The mean times of hospital stay were comparable between patients with mild drug eruptions and severe drug eruptions (9.02±3.58 days). Systemic glucocorticoids were given to 46(51.69%) patients, including 4 cases of severe drug eruptions, two of each treated together with immunoglobulin and tumor necrosis factor (TNF)-α antagonist, respectively. No deaths were found during the follow-up. Conclusions Exanthematous eruption is the most common type of drug eruptions, while the common allergenic drugs are antibiotics, traditional Chinese medicines and antiepileptics. Large portion of patients with drug eruptions, especially severe cases, experience high fever at the early stage. However, hospitalization time does not differ between patients with severe and mild drug eruptions. Early administration of sufficient glucocorticoids alone or in combination with other therapies can shorten the hospitalization time for severe drug eruptions.

Keywords

• drug eruption
• β-lactam antibiotics
• carbamazepine
• lamotrigine
• glucocorticoid