Drug-related hospital admissions--an overview of frequency and clinical presentation.

Adverse drug reactions (ADR) are the cause of hospital admissions for millions of patients every year and are believed to be a major problem in terms of morbidity and hospital expenses. ADR are characterized by exceptional variety, both considering pathomechanism and clinical symptoms. During the time period between 2000-2004 at the Department of Dermatology a project was undertaken to monitor patients who were hospitalized as a result of ADR. Within five years 57 patients, including 30 men and 27 women were observed. The majority of the patients developed maculaopapular rash (16), urticaria medicamentosa and Quincke's edema (16) and erythema multiforme (15). The other cases included erythroderma (5), anaphylactic shock (2), lichenoid exanthem (1), bullous eruption (1) and Hoigne's syndrome (1). The most probable factors producing these changes were concluded to be non-steroid antiinflammation drugs (33%), antibiotics (7%) and other drugs from different pharmacological and chemical groups (carbamazepine, diltiazem, hydrocortisone, methotrexate and herbs). The frequency of occurrence of skin changes of particular type in age groups were also analyzed. The greatest number of skin changes in response to drug therapy was in the age group 41 - 60, while for the age group > 60 ADR revealed the greatest diversity in the clinical picture. The most probable explanation of these findings are the polypragmasy applied in the elderly patients and interdrug interaction as well as decreased efficiency of the organic clearances.