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J Clin Pharm Ther. 2021 Aug;46(4):950-956. doi: 10.1111/jcpt.13376. Epub 2021 Feb 10.

Risk comparison of beta-lactam-induced anaphylaxis: Therapeutic stratification analysis in a Vietnamese pharmacovigilance database.

Journal of clinical pharmacy and therapeutics

Khac-Dung Nguyen, Dinh-Hoa Vu, Hoang-Anh Nguyen, Van-Tu Dao, Jean-Louis Montastruc, Haleh Bagheri

Affiliations

  1. The National Centre of Drug Information and Adverse Drug Reaction Monitoring, Hanoi University of Pharmacy, Hanoi, Vietnam.
  2. Laboratoire de Pharmacologie Médicale et Clinique, Faculté de Médecine de l'Université Paul-Sabatier (Medical and Clinical Pharmacology Laboratory, Faculty of Medicine Paul-Sabatier University) and Centre de PharmacoVigilance, de Pharmacoépidémiologie et d'Information sur le Médicament de Toulouse (Centre for Pharmacovigilance, Pharmacoepidemiology and Drug Information), UMR INSERM 1027, Centre Hospitalier Universitaire de Toulouse (Toulouse University Hospital Centre), Toulouse, France.
  3. Cancer Research and Clinical Trial Center, National Institute for Cancer Control, Vietnam National Cancer Hospital, Hanoi, Vietnam.

PMID: 33565097 DOI: 10.1111/jcpt.13376

Abstract

WHAT IS KNOWN AND OBJECTIVE: There is limited data on the specific risks of anaphylaxis induced by beta-lactam drugs. The aim of this study was to compare the risks of reporting beta-lactam-induced anaphylaxis using the national pharmacovigilance database of Vietnam (NPDV).

METHODS: The multivariate generalised linear regression model was applied for signal generation and comparison of beta-lactams.

RESULTS: Between 2010 and 2016, there were 2,921 reports of anaphylaxis (19.93%) from 14,655 spontaneous reports of beta-lactam use in the NDPV. Anaphylaxis signal generation was also found for the subgroup J01D (cephalosporins and carbapenems) (ROR = 1.27 [1.16-1.39]) and beta-lactamase-sensitive penicillins (ROR = 1.74 [1.27-2.35]). In the third generation cephalosporin subgroup, different risks were identified for the following combinations of beta-lactams: 1) cefotaxime with cefoperazone+sulbactam; 2) cefixime/cefpodoxime/cefdinir with cefoperazone+sulbactam or ceftizoxime/cefoperazone/ceftazidime/ceftriaxone/cefotaxime. For the second generation cephalosporin subgroup, different risks were found for cefotiam compared to cefmetazole, cefaclor, cefamandole and cefuroxime.

WHAT IS NEW AND CONCLUSION: These findings identified and highlighted the different anaphylactic risks caused by various beta-lactams in the main subgroups.

© 2021 John Wiley & Sons Ltd.

Keywords: beta-lactam; developing countries; drug-induced anaphylaxis

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