Gilkey Ty, Trinidad John, Kovalchin Claire, Minta Abena, Rosenbach Misha, Kaffenberger Benjamin H
Mr. Gilkey, Ms. Kovalchin, and Ms. Minta are with the Medical Student Research Program at The Ohio State College of Medicine in Columbus, Ohio.
Drs. Kaffenberger and Trinidad are with the Department of Internal Medicine in the Division of Dermatology at The Ohio State University Wexner Medical Center in Columbus, Ohio.
J Clin Aesthet Dermatol. 2022 Jun;15(6):59-64.
We sought to evaluate medication exposures during an entire hospitalization, with the goal of describing medications and demographic conditions that are associated with developing a drug eruption during hospitalization.
468 patients that developed a cutaneous drug eruption were identified from a cohort of 18,140 unique inpatients with dermatologic diagnoses; medication lists and demographic information were assimilated, and drug eruption frequency tables were created.
The agents most commonly associated with drug eruptions included many antineoplastic, antifungal, and antibiotic therapeutics: idarubicin (27.78% reaction rate), daunorubicin (26.43%), sorafenib (25.00%), lenalidomide (23.53%), all-trans-retinoic acid (22.58%), decitabine (21.57%), aztreonam (15.15%), posaconazole (14.29%), and voriconazole (13.78%) among many others. Patients diagnosed with drug eruptions were more likely to have private insurance (3.29% vs. 2.58% reaction rate) and were on average older (56.7 vs. 52.6 years), had longer inpatient stay (14.2 vs. 7.9 days), and higher inpatient mortality (5.95% vs. 2.58%) than patients without eruptions.
This was a single-center cross-sectional study. Drug reaction codes were used substantially less frequently than more general codes for non-specific eruptions, further, the analysis was stratified by full hospitalization data to account for delayed reactions.
Hospitalizations in which patients receive medications common to malignancies, such as cytotoxic and antifungal therapies represent the highest risk hospitalizations for the development of drug eruptions. When diagnosing and treating drug eruptions, clinicians should consider these medication classes with a high index of suspicion.
我们试图评估整个住院期间的药物暴露情况，目的是描述与住院期间发生药物疹相关的药物和人口统计学状况。
从18140名患有皮肤病诊断的独特住院患者队列中识别出468例发生皮肤药物疹的患者；收集药物清单和人口统计学信息，并创建药物疹频率表。
与药物疹最常相关的药物包括许多抗肿瘤、抗真菌和抗生素治疗药物：伊达比星（反应率27.78%）、柔红霉素（26.43%）、索拉非尼（25.00%）、来那度胺（23.53%）、全反式维甲酸（22.58%）、地西他滨（21.57%）、氨曲南（15.15%）、泊沙康唑（14.29%）和伏立康唑（13.78%）等。被诊断为药物疹的患者更有可能拥有私人保险（反应率3.29%对2.58%），平均年龄更大（56.7岁对52.6岁），住院时间更长（14.2天对7.9天），住院死亡率更高（5.95%对2.58%），比没有发生皮疹的患者。
这是一项单中心横断面研究。药物反应编码的使用频率远低于非特异性皮疹的更通用编码，此外，分析按整个住院数据分层以考虑延迟反应。
患者接受恶性肿瘤常用药物（如细胞毒性和抗真菌治疗）的住院治疗是发生药物疹的最高风险住院治疗。在诊断和治疗药物疹时，临床医生应高度怀疑地考虑这些药物类别。
