Incidence, causative drugs, and economic consequences of drug-induced SJS, TEN, and SJS–TEN overlap and potential drug–drug interactions during treatment: a retrospective analysis at an Indonesian referral hospital
Received 20 May 2017
Accepted for publication 28 June 2017
Published 21 July 2017 Volume 2017:13 Pages 919—925
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Lucy Goodman
Peer reviewer comments 2
Editor who approved publication: Professor Garry Walsh
Rizky Abdulah,1 Tazkia F Suwandiman,1 Nadhira Handayani,1 Dika P Destiani,1 Auliya A Suwantika,1 Melisa I Barliana,2 Keri Lestari1
1Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, 2Department of Biological Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
Background: Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute life-threatening adverse drug reactions (ADRs) that are commonly caused by medications. Apart from their contribution to morbidity and mortality, these diseases may also present substantial consequences on health care resources. In this study, we aimed to identify the incidence, causative drugs, and economic consequences of these serious ADRs and potential drug–drug interactions (DDIs) during treatment.
Methods: A retrospective study that included 150 patients diagnosed with drug-induced SJS, SJS–TEN overlap, and TEN, from 2009 to 2013 in a referral hospital in West Java Province, Indonesia, was conducted to analyze the causative drugs, cost of illness (COI) as a representation of economic consequences, and potential DDIs during treatment.
Results: The results showed that analgesic–antipyretic drugs were the most frequently implicated drugs. The COIs for SJS, SJS–TEN overlap, and TEN patients were 119.49, 139.21, and 162.08 US dollars per day, respectively. Furthermore, potential DDIs with several therapeutic medications and corticosteroids used to treat SJS, SJS–TEN overlap, and TEN were also identified.
Conclusion: This study showed that analgesic–antipyretic was the major causative drug which contributed to SJS, SJS–TEN overlap, and TEN. Furthermore, our results also showed that SJS, SJS–TEN overlap, and TEN may cause considerable financial consequences to patients.
Keywords: Stevens–Johnson syndrome, toxic epidermal necrolysis, adverse drug reactions, cost of illness