DRUG-INDUCED URTICARIA: IMPLICATED DRUGS, REACTION RECOVERY TIME AND CAUSALITY ASSESSMENT -A FIVE-YEAR RETROSPECTIVE STUDY

Introduction: Cutaneous Adverse drug reactions presenting as urticaria are the most frequent local and systemic adverse reactions (ADR). Urticaria is a skin disorder resulting from the vascular reaction of the skin characterized by erythema and wheal formation due to a localized increase of vascular permeability. It affects up to 20 % of the population at some point during their life and can be acute or chronic. Acute Urticaria can be etiologically due to infection, drugs, and food; and usually resolves within ≤ 6 weeks. Itching and rash are diagnosed clinically due to either type I hypersensitivity (IgE dependent) or type III hypersensitivity Immune complex. Material and Methodology: This 5-year retrospective observational study was conducted at Pt. JNM Medical College associated with DR. BRAM Hospital. All Individual Case Safety Reports (ICSRs) were analyzed from the Adverse Drug Reaction Monitoring Centre (AMC) database under PvPI between 1st January 2018 to 31st December 2022, and all Drug induced Urticaria were included. Results: Of the total 1425 ICSRs, 53(3.7%) reactions were identified as Urticaria with female preponderance (58.4%), and parenteral routes accounted for 58.4% of cases. Antibiotics were the most common offenders (45.2%) where Beta-lactams accounted for 32% of reactions, and prominently feature ceftriaxone a third-generation Cephalosporin responsible for 15% of total urticaria. This was followed by analgesic paracetamol (13.2%), and anti-rabies vaccine 5.6%. The reaction subsided within 1 day in 39.6% of cases, 2 days in 49 %, and 3- 7 days in 11.3% of cases. According to the WHO -UMC Causality scale 84.9 % were “probable” and 2 cases were “certain” and where due to Vancomycin and FDC of ibuprofen paracetamol. Conclusion: Beta-lactam antibiotics (ceftriaxone) are the most common cause of drug-induced urticaria, early onset and resolution suggest they are acute urticaria and the majority were probable.