Chaby G, et al. - Experts intended to evaluate the proportion of severe cutaneous adverse reactions (SCARs) associated with inappropriate medication use. Based on the results, a necessity arose for respecting the appropriate indication of drugs with the intention of reducing the incidence of SCARs. Findings laid stress on targeting efforts to reduce unintentional rechallenge for necessary preventive measures.

Methods

• The design of this research was a retrospective study.
• It included all validated SCARs collected in a French registry between 2003 and 2016.
• For each case, consideration of all plausible drugs suspected to induce SCARs (ie, not just the drug regarded as “the most probable”) was undertaken in terms of 3 causes of preventability:
• Prescription for an inappropriate indication,
• Unintentional rechallenge despite a previous allergy to the drug, or
• Self-medication with prescription medicines.

Results

• This study comprised of 602 cases.
• It was determined that antibiotics, anticonvulsants and allopurinol were the drugs most frequently involved, accounting for more than 50% of all cases.
• Herein, all suspected medications were regarded as being appropriately used for 417 out of the 602 subjects included in the study cohort (69.3%, 95% CI [65.6-73.0]).
• Medications were considered as inappropriately used for 144 candidates (23.9% [20.5-27.3]).
• Such inappropriate uses were primarily attributed to prescriptions for inappropriate indication (65.8% [58.4-73.2]) or unintentional rechallenge (20.9% [14.6-27.2]).
• The drugs most frequently involved in inappropriate indications (accounting for 51.9% [42.3-61.5] and 13.5% [6.9-20.1] of cases, respectively) were discovered to be allopurinol and cotrimoxazole.
• It was deduced that antibiotics served as the largest group involved in unintentional rechallenge.
• Data indicated that non-steroidal anti-inflammatory drugs available on prescription appeared to be most involved in inappropriate self-medication.