IADVL
Indexed with PubMed and Science Citation Index (E) 
 
Users online: 1817 
     Home | Feedback | Login 
About Current Issue Archive Ahead of print Search Instructions Online Submission Subscribe What's New Contact  
  NAVIGATE Here 
    Next article
    Previous article
    Table of Contents

 RESOURCE Links
    Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
  Related articles
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed13881    
    Printed330    
    Emailed17    
    PDF Downloaded678    
    Comments [Add]    
    Cited by others 10    

Recommend this journal

 

 ORIGINAL ARTICLE
Year : 2013  |  Volume : 79  |  Issue : 3  |  Page : 389--398

A systematic review of the drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Indian population


1 Department of Pharmacology, GMERS Medical College, Gotri, Vadodara, Gujarat, India
2 Department of Pharmacology, Government Medical College, Bhavnagar, Gujarat, India

Correspondence Address:
Tejas K Patel
Department of Pharmacology, GMERS Medical College, Gotri 390 021, Gujarat
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0378-6323.110749

Rights and Permissions

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare severe cutaneous drug reactions. No large scale epidemiological data are available for this disorder in India. Aims: To carry out a systematic review of the published evidence of the drug-induced SJS and TEN in Indian population. Methods: Publications from 1995 to 2011 describing SJS and TEN in Indian population were searched in PubMed, MEDLINE, EMBASE and UK PUBMED Central electronic databases. Data were collected for the causative drugs and other clinical characteristics of SJS and TEN from the selected studies.Results: From 225 references, 10 references were included as per selection criteria. The major causative drugs were antimicrobials (37.27%), anti-epileptics (35.73%) and non-steroidal anti-inflammatory drugs (15.93%). Carbamazepine (18.25%), phenytoin (13.37%), fluoroquinolones (8.48%) and paracetamol (6.17%) were most commonly implicated drugs. Regional differences were observed for fluoroquinolones, sulfa drugs and carbamazepine. Total 62.96% of patients showed systemic complications. Most common complications were ocular (40.29%) and septicemia (17.65%). Higher mortality was observed for TEN as compared to SJS (odd ratio-7.19; 95% confidence interval (CI) 1.62-31.92; p = 0.0023). Observed mortality is higher than expected as per SCORTEN score 3. Duration of hospital stay was significantly higher in TEN (20.6 days; 95% CI 14.4-26.8) as compared to SJS (9.7 days; 95% CI 5.8-13.6; p = 0.020). Cost of management was significantly higher in TEN (Rs. 7910; 95% CI 5672-10147; p < 0.0001) as compared to SJS (Rs 2460; 95% CI 1762-3158). No statistical data were described for steroid use in the studies included. Conclusion: Carbamazepine, phenytoin, fluoroquinolones and paracetamol were the major causative drugs. TEN is showing higher mortality, morbidity and economic burden than SJS.






[FULL TEXT] [PDF]*


        
Print this article     Email this article

Online since 15th March '04
Published by Wolters Kluwer - Medknow