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Stevens-johnson syndrome associated with drugs and vaccines in children: a case-control study

Umberto Raucci1, Rossella Rossi, Roberto Da Cas

  • 1Paediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Roma, Italy.

Plos One
|July 23, 2013
PubMed

Insights

Drug use significantly increases the risk of Stevens-Johnson Syndrome (SJS) in children, with anticonvulsants posing the highest danger. Vaccines, however, showed no association with SJS occurrence.

Area of Science:

  • Pediatric pharmacology
  • Dermatology
  • Epidemiology

Background:

  • Stevens-Johnson Syndrome (SJS) is a severe mucocutaneous reaction, frequently linked to medication use.
  • Understanding the specific risks associated with drug and vaccine exposure in children is crucial for public health.
  • Previous studies have suggested a link between certain medications and SJS, but pediatric-specific data require further investigation.

Purpose of the Study:

  • To quantify the association between drug and vaccine use and the incidence of Stevens-Johnson Syndrome in pediatric patients.
  • To identify specific drug classes that may elevate the risk of SJS in children.
  • To evaluate the safety of vaccines concerning SJS development in the pediatric population.

Main Methods:

  • A multicenter surveillance study was conducted in Italy, involving children hospitalized for acute conditions.
  • Cases diagnosed with SJS were identified, and their parents were interviewed regarding preceding drug and vaccine exposure.
  • A control group of children hospitalized for acute neurological conditions was used for comparison.

Main Results:

  • The study included 29 children with SJS and 1,362 controls. Drug exposure was higher in SJS cases (79%) compared to controls (58%).
  • Anticonvulsants demonstrated the highest adjusted odds ratio (OR) for SJS (26.8). Antibiotics (OR 3.3), corticosteroids (OR 4.2), and paracetamol (OR 3.2) also showed increased risks.
  • No significant increase in SJS risk was associated with vaccine use (OR 0.9).

Conclusions:

  • This study provides robust evidence implicating various drug classes in the etiology of SJS in children.
  • Anticonvulsants, antibiotics, corticosteroids, and paracetamol are identified as significant risk factors for SJS in pediatric populations.
  • Current vaccination practices do not appear to increase the risk of SJS in children.
Abstract

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