Comparison of Characteristics and Outcome of The Patients with DRESS Who Received Culprit Drugs as Inpatient and Outpatient Basis
Abstract
Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous adverse reaction (SCAR), life-threatening with multiple internal organs involvement. The difference between inpatient and outpatient cases have not been reported.
Objective: To compare the characteristics and outcome of the patient with DRESS who received culprit drugs as inpatient and outpatient basis. Materials and
Method: This was a prospective study in a total of 64 patients visiting the division, who were diagnosed with DRESS according to the RegiSCAR criteria (score ≥ 4). We compared the results of demographic data, clinical presentation, laboratory, and mortality rate between inpatient and outpatient cases.
Results: Among the 64 patients, the inpatient cases were 47% and outpatient cases were 53%. The most common culprit drugs were antibiotic drugs in inpatient cases and anti-epileptic drugs in the outpatient cases. Time interval to detect DRESS of inpatient cases were shorter than that of outpatient cases (13 days versus 22 days); P-value = 0.001. Antibiotic drugs were significantly higher in inpatient cases (P-value = 0.005). Allopurinol, facial edema, lymphadenopathy, atypical lymphocytes and RegiSCAR score were significantly higher in outpatient cases (P-value = 0.005, 0.001, 0.021, 0.031, and 0.047 respectively). Mortality rate was not significantly different in both cases.
Conclusion: The difference between inpatient and outpatient cases were time interval to detect DRESS, facial edema, lymphadenopathy, atypical lymphocytes and RegiSCAR score. This data can be useful to manage the patients with DRESS.
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