28
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Epidemiology of hypersensitivity drug reactions.

      Current Opinion in Allergy and Clinical Immunology
      Adverse Drug Reaction Reporting Systems, Drug Hypersensitivity, diagnosis, epidemiology, etiology, Female, France, Humans, Incidence, Inpatients, statistics & numerical data, Male, Outpatients, Prevalence, Risk Factors, Severity of Illness Index, Skin Tests, Survival Rate

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Hypersensitivity drug reactions are but one of the many different types of adverse drug reactions. They may be potentially life-threatening, prolong hospitalization, affect drug prescribing patterns of physicians and result in socioeconomic costs. This review summarizes current knowledge on the incidence, prevalence, mortality and risk factors for these reactions in different populations. Hypersensitivity reactions represent about one third of all adverse drug reactions. Adverse drug reactions affect 10-20% of hospitalized patients and more than 7% of the general population. Severe reactions including anaphylaxis, drug hypersensitivity syndromes, Stevens Johnson syndrome and toxic epidermal necrolysis are also associated with significant morbidity and mortality. Although several risk factors have been identified, their clinical importance has not been fully understood. Future progress in immunogenetics and pharmacogenetics may help identify populations at risk for specific types of reactions. Well designed epidemiological studies on hypersensitivity drug reactions are lacking as most studies have been on adverse drug reactions. Such studies will be helpful in identifying patients at risk of developing such reactions, in particular severe reactions, and implementing early preventive measures.

          Related collections

          Most cited references4

          • Record: found
          • Abstract: found
          • Article: not found

          Drug provocation tests in patients with a history suggesting an immediate drug hypersensitivity reaction.

          Drug hypersensitivity reactions are common and can be life-threatening. Confirmation of the diagnosis should be rigorous and based on clinical history and a physical examination, possibly followed by skin tests and drug provocation tests. To describe the outcome of drug provocation tests in evaluating patients with histories suggesting drug allergy. Retrospective analysis of clinic case series. The department for drug allergy at a university hospital. 898 consecutive patients with suspected immediate drug allergy referred to the clinic between September 1996 and August 2001. Patients with severe skin reactions and those with positive results on skin tests for beta-lactams were excluded. Single-blinded administration of increasing doses of the suspected drug, up to the usual daily dose, under strict hospital surveillance. 1372 drug provocation tests were performed using various drugs, including beta-lactams (30.3%), aspirin (14.5%), other nonsteroidal anti-inflammatory drugs (11.7%), paracetamol (8.9%), macrolides (7.4%), and quinolones (2.4%). There were 241 (17.6%) positive drug provocation test results. Drug provocation reproduced the same symptoms, albeit milder and of a shorter duration, in the following patients: 13 (5.4%) with a history of anaphylactic shock, 17 (7.0%) with a history of anaphylaxis without shock, 10 (4.1%) with a history of laryngeal edema, 19 (7.9%) with a history of bronchospasm, 160 (66.4%) with a history of urticaria, and 22 (9.1%) with a history of maculopapular eruption. All adverse reactions were completely reversed by prednisolone, H(1)-antihistamines, and epinephrine as needed. Falsely negative results on drug provocation tests may have occurred because of loss of sensitization, rare cofactors not included in the diagnostic procedure, and tolerance induction during provocation. Drug provocation tests in individuals with suspected drug allergy performed in carefully controlled settings can confirm drug hypersensitivity.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            How Many Hours Is Enough? An Old Profession Meets a New Generation

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Epidemiology of drug allergy.

              Adverse drug reactions occur in 10-20% of hospitalized patients, and up to one-third of these are of an allergic or pseudo-allergic nature. Allergic reactions are unpredictable adverse effects that are linked to immunological mechanisms. Pseudo-allergic reactions are unpredictable adverse reactions that are clinically similar to allergic reactions, but for which there are no drug-specific antibodies or T lymphocytes. There is a paucity of tools that allow a definite diagnosis, and most of the available ones still require validation. Therefore, there are few true epidemiological data, and most of those that are available, including incidence, mortality and socioeconomic impact data, should be interpreted with caution.
                Bookmark

                Author and article information

                Comments

                Comment on this article