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Skin reactions to antibacterial agents in general practice
P D van der Linden1, J van der Lei, A E Vlug
1Department of Epidemiology & Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
Journal of Clinical Epidemiology
|September 22, 1998
Summary
Skin reactions to antibacterial drugs occur in about 1% of general practice patients. Trimethoprim-sulfonamides, penicillins, and fluoroquinolones showed the highest risk for these adverse drug reactions.
Area of Science:
- Pharmacovigilance
- Dermatology
- General Practice Research
Background:
- Antibacterial drugs are widely prescribed in primary care.
- Skin reactions are a common adverse drug event.
- Quantifying this risk in a large, general population is crucial.
Purpose of the Study:
- To determine the incidence of skin reactions associated with antibacterial drug use in a general practice setting.
- To identify specific antibacterial drug classes with higher risks of skin reactions.
Main Methods:
- Retrospective cohort study using the Integrated Primary Care Information (IPCI) database.
- Involved approximately 150,000 individuals over a 1.5-year period.
- Defined a risk period of drug duration plus 14 days to capture skin reactions.
Main Results:
- 13,679 patients received 19,961 antibacterial prescriptions; 135 developed skin reactions (approx. 1%).
- Highest incidence was observed for trimethoprim-sulfonamides (2.1%), fluoroquinolones (1.6%), and penicillins (1.1%).
- Incidence density ratios indicated significantly higher risks for these drug classes compared to tetracyclines.
Conclusions:
- The overall frequency of skin reactions to antibacterials in general practice is approximately 1%.
- Trimethoprim-sulfonamides, penicillins, and fluoroquinolones are associated with the highest risk.
- Outpatient incidence is likely lower than in hospitalized patients, potentially due to less susceptible populations.