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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Drug Fever: a descriptive cohort study from the French national pharmacovigilance database

Dominique Vodovar1, Christine LeBeller, Bruno Mégarbane

  • 1Department of Internal Medicine, AP-HP, Ambroise Par Hospital, Boulogne-Billancourt, France.

Drug Safety
|July 27, 2012
PubMed
Abstract

Insights

Drug fever (DF) is a rare adverse drug reaction. Antibacterial drugs are the most common cause of DF, necessitating careful diagnosis and management to ensure favorable outcomes.

Area of Science:

  • Pharmacovigilance
  • Drug Safety
  • Clinical Medicine

Background:

  • Drug fever (DF) is a rare but significant adverse drug reaction (ADR).
  • Limited data exists on drugs associated with DF, impacting clinical decision-making.
  • DF can lead to unnecessary diagnostic and therapeutic interventions.

Purpose of the Study:

  • To identify drugs associated with drug fever (DF).
  • To analyze the outcomes of patients experiencing DF.
  • To provide data on DF for improved medical practice.

Main Methods:

  • Analysis of DF cases without skin reactions from the French National Pharmacovigilance Database (1986-2007).
  • Qualitative (Naranjo's criteria) and quantitative (proportional reporting ratio [PRR]) assessment of implicated drugs.
  • Inclusion criteria: ≥3 cases, PRR ≥2, Chi-squared ≥4.

Main Results:

  • 167 DF cases involving 115 drugs were analyzed.
  • 22 drugs were significantly associated with DF, with antibacterials being the most frequent class.
  • Median time to fever onset was 2 days; fever resolved in 3 days after drug cessation. Recurrence confirmed DF in 38% of cases upon rechallenge.

Conclusions:

  • Diagnosing drug fever (DF) presents challenges in clinical practice.
  • Antibacterial agents are the primary drug class implicated in DF.
  • Prompt drug discontinuation leads to favorable outcomes in most DF cases.

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