Stevens–Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database

Bernardo Sousa-Pinto; Luís Araújo; Alberto Freitas; Osvaldo Correia; Luís Delgado

doi:10.1186/s13601-017-0188-1

Table 3 Drug classes deemed responsible for the cutaneous adverse reactions occurred in the context of hospitalisations with an associated diagnosis of erythema multiforme (EM) or Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN); Mainland Portugal, 2009–2014 (n = 254 hospitalisations)

From: Stevens–Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database

Drug class—n (%)	Cutaneous adverse reactions			SJS/TEN
Drug class—n (%)	EM (N = 122)	SJS/TEN (N = 132)	P value	SJS (N = 73)	SJS–TEN overlap^a (N = 18)	TEN (N = 41)	P value
Antibiotics	36 (29.5)	34 (25.8)	0.504	18 (24.7)	6 (33.3)	10 (24.4)	0.731
Penicillins	9 (7.4)	9 (6.8)	0.862	2 (2.7)	4 (22.2)	3 (7.3)	0.016
Other specified antibiotics^a	22 (18.0)	22 (16.7)	0.774	14 (19.2)	1 (5.6)	7 (17.1)	0.380
Unspecified antibiotics	4 (3.3)	2 (1.5)	0.431	1 (1.4)	–	1 (2.4)	0.999
Other anti-infectives	10 (8.2)	18 (13.6)	0.167	12 (16.4)	4 (22.2)	2 (4.9)	0.117
Sulfonamides	4 (3.3)	8 (6.1)	0.296	5 (6.8)	2 (11.1)	1 (2.4)	0.285
Antimycobacterial drugs	1 (0.8)	2 (1.5)	0.999	2 (2.7)	–	–	0.654
Antiviral drugs	1 (0.8)	7 (5.3)	0.068	4 (5.5)	2 (11.1)	1 (2.4)	0.340
Hormones and synthetic substitutes	7 (5.7)	7 (5.3)	0.879	5 (6.8)	2 (11.1)	–	0.126
Antineoplastic and immunosuppressive drugs^b	13 (10.7)	7 (5.3)	0.114	3 (4.1)	1 (5.6)	3 (7.3)	0.759
Agents primarily affecting blood constituents	–	4 (3.0)	0.123	2(2.7)	1 (5.6)	1 (2.4)	0.611
Analgesics, antipyretics, and antirheumatics	11 (9.0)	7 (5.3)	0.249	3 (4.1)	1 (5.6)	3 (7.3)	0.759
Anticonvulsants	13 (10.7)	22 (16.7)	0.165	12 (16.4)	2 (11.1)	8 (19.5)	0.726
Sedatives and hypnotics	–	1 (0.8)	0.999	–	1 (5.6)	–	0.136
Psychotropic agents	2 (1.6)	4 (3.0)	0.685	2 (2.7)	–	2 (4.9)	0.789
Agents primarily affecting the cardiovascular system	2 (1.6)	2 (1.5)	0.999	1 (1.4)	–	1 (2.4)	0.999
Uric acid metabolism drugs^c	21 (17.2)	26 (19.7)	0.611	17 (23.3)	2 (11.1)	7 (17.1)	0.447
Agents primarily acting on the smooth and skeletal muscles and respiratory system	1 (0.8)	–	0.480	–	–	–
Agents primarily affecting skin and mucous membrane, ophthalmological, otorhinolaryngological and dental drugs	1 (0.8)	–	0.480	–	–	–
Other and unspecified drugs and medicinal substances^d	9 (7.4)	12 (9.1)	0.620	7 (9.6)	–	5 (12.2)	0.368

^aIncludes, among others, macrolides, tetracyclines, and cephalosporins
^bThese were the only drugs of the class “primarily systemic agents” in which cutaneous adverse reactions were registered
^cThese were the only drugs of the class “water, mineral, and uric acid metabolism drugs” in which cutaneous adverse reactions were registered
^dThere were no cutaneous adverse reactions associated with use of drugs belonging to the classes “other central nervous system depressants and anesthetics”, “central nervous system stimulants”, “drugs primarily affecting the autonomic nervous system” and “agents primarily affecting gastrointestinal system”

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