Mm. Vanderklauw et al., DRUG-ASSOCIATED ANAPHYLAXIS - 20 YEARS OF REPORTING IN THE NETHERLANDS (1974-1994) AND REVIEW OF THE LITERATURE, Clinical and experimental allergy, 26(12), 1996, pp. 1355-1363
Background Since 1963, the Drug Safety Unit of the Dutch Inspectorate
for Health Care (DSU) holds a voluntary reporting system. Objective To
analyse all reports received in the years 1974 to 1994, registered as
anaphylaxis or as a diagnosis that could contain cases of anaphylaxis
. Methods All reports were classified as probable or possible anaphyla
xis according to previously described criteria and the causal relation
ship between exposure and anaphylaxis was assessed. Results Nine hundr
ed and ninety-two reports possibly concerning anaphylaxis were receive
d between 1974 and 1994. Fifty-six were unclassifiable. The remaining
936 reports concerned 326 men and 610 women. Three hundred and forty-f
ive reports were classified as anaphylaxis probable, 485 as anaphylaxi
s possible, and 106 as anaphylaxis unlikely by previously specified cr
iteria. Drugs frequently associated with anaphylaxis (causal relations
hip certain or probable) were: glafenine (326 reports classified as an
aphylaxis probable or possible), combination preparations with (propy)
phenazone or propyphenazone/phenacetine (39), diclofenac (30), dextran
(20), ibuprofen (14), floctafenine (12), allergen extracts (12), sulf
amethoxazole with trimethoprim (12), and trimethoprim (11). There is p
robably substantial under-reporting as well as reporting bias in these
data. Furthermore, many reports were classified as possible and not a
s probable anaphylaxis because the temporal relationship was unknown o
r not reported. Conclusion Drugs that caused anaphylaxis most frequent
ly were glafenine, NSAID and certain antibiotics. Data from a voluntar
y reporting system such as the DSU are valuable as an early warning sy
stem for drugs that may induce anaphylactic reactions.