MONDAY, Aug. 12, 2024 (HealthDay News) — Sulfonamide antibiotics and cephalosporins are most strongly associated with serious cutaneous adverse drug reactions (cADRs), according to a study published online Aug. 8 in the Journal of the American Medical Association.
Erika Y. Lee, M.D., from the University of Toronto, and colleagues explored the risk for serious cADRs associated with commonly prescribed oral antibiotics and characterized outcomes of patients hospitalized for them in a nested case-control study using data for adults aged 66 years or older who received at least one oral antibiotic between 2002 and 2022. Cases were those with an emergency department visit or hospitalization for serious cADRs within 60 days of the prescription (21,758 older adults); each case was matched to four controls without emergency department visit or hospitalization for cADRs (87,025 matched controls).
The researchers found that sulfonamide antibiotics and cephalosporins were most strongly associated with serious cADRs relative to macrolides in the primary analysis (adjusted odds ratios, 2.9 and 2.6, respectively). In addition, associations were seen for nitrofurantoin, penicillins, and fluoroquinolones (adjusted odds ratios, 2.2, 1.4, and 1.3, respectively). The highest crude rate of emergency department visits or hospitalization for cADRs was seen for cephalosporins and sulfonamide antibiotics (4.92 and 3.22 per 1,000 prescriptions, respectively). The median length of stay was six days among the 2,852 case patients hospitalized for cADRs; 9.6 and 5.3 percent required transfer to a critical care unit and died in the hospital, respectively.
“The findings highlight the risk of serious cADRs following commonly prescribed antibiotics and underscore the importance of judicious prescribing, with preferential use of those associated with a lower risk when clinically appropriate,” the authors write.
One author disclosed ties to the publishing industry; a second author disclosed ties to the pharmaceutical industry.
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