Abstract

CLINICAL PATTERN OF COMMON CUTANEOUS DRUG REACTIONS DUE TO SYSTEMIC ANTIBIOTICS IN PATIENTS ATTENDED KHARTOUM DERMATOLOGY AND VENEREAL DISEASES TEACHING HOSPITAL – SUDAN

Mohammed Helmy Faris Shalayel*, Ietimad Abdelsalam Mohamed Ayed and Yousif Mohammed Kordofani

Abstract

A prospective descriptive hospital-based study was conducted in Khartoum Dermatology and Venereal diseases Teaching Hospital in the period from October 2015 to April 2016. The objectives of the study were to reveal the different clinical types of cutaneous drug reactions due to systemic antibiotics and to show the most common offending drugs causing cutaneous drug reactions. The study included 41 patients; 28 female patients (68.3%) and 13 male patients (31.7%). The age mean of patients was 38.44 ± 14.26 (mean ± S.D.) ranging between 4 – 70 years. Of patients included in the study, 35 patients (85.4 %) had past history of drug reactions while only 6 ones (14.6 %) did not have. Our study revealed that the highest offending antibiotic implicated to cause drug reaction was ciprofloxacin (41.5%) followed by the antimalarial artesunate and sulfadoxine-pyrimethamine (12.2%), septrin (sulfamethoxazole/Trimethoprim) (9.8%), norfloxacin (7.3%), ceftriaxone (4.9%), penicillin (4.9%), amoxicillin (4.9), ampicillin/cloxacillin (ampiclox) (2.4%), amoxicillin/clavulanate (amoclan) (2.4%), tetracycline (2.4%), erythromycin (2.4%), and Clarithromycin(2.4%). Maculopapular rash was seen in 16 cases (39%), SJS was found in 7 cases (17.07%), TEN in 7 cases (17.07%), SJS/TEN overlap in 4 cases (9.8%), EM-major in 6 cases (14.6%) and fixed drug eruption (FDE) in 1 case (2.4%). It was concluded that Antibiotics comprise the major impact of the drug family and inpatient and outpatient prescriptions and thus are the most irrationally prescribed drug class. So implementation of antibiotic guidelines for the hospital scenario and strict adherence should be ensured to promote the rational use.

Keywords: Adverse cutaneous drug reactions (ACDRs); Steven Johnson Syndrome (SJS); toxic epidermolysis necrolysis (TEN); erythema multiforme (EM); Antibiotics.