Table 2.
Culprit drugs responsible for SJS/TEN in adults, Clalit, 2008–19
| Drug name | Number of SJS/TEN cases | Number of SJS/TEN cases with true diagnosis | Number of SJS/TEN cases with probable diagnosis | ALDEN score (mean) | SD | Total adult new-users of drug in the study period | SJS/TEN adult cases/10,000 new users of the drug |
|---|---|---|---|---|---|---|---|
| Allopurinol | 11 | 10 | 1 | 5.18 | 1.85 | 100,141 | 1.10 |
| Lamotrigine | 9 | 7 | 2 | 5.67 | 0.67 | 31,954 | 2.82 |
| Phenytoin | 8 | 8 | 0 | 4.5 | 1.50 | 22,458 | 3.56 |
| Amoxicillin | 6 | 6 | 0 | 3 | 1.53 | 2,190,927 | 0.03 |
| Ciprofloxacin | 6 | 2 | 4 | 3 | 1.00 | 846,757 | 0.07 |
| Etoricoxib | 5 | 4 | 1 | 5.75 | 0.43 | 951,325 | 0.05 |
| Trimethoprim-sulfamethoxazole | 4 | 4 | 0 | 2 | 2.92 | 153,670 | 0.26 |
| Valproic acid | 4 | 2 | 2 | 3 | 0.82 | 58,729 | 0.68 |
| Clindamycin | 4 | 3 | 1 | 2.5 | 0.87 | 120,435 | 0.33 |
| Cefuroxime | 4 | 3 | 1 | 4 | 1.22 | 1,396,231 | 0.02 |
| Amoxicillin-clavulanate | 4 | 4 | 0 | 3.25 | 1.09 | 1,960,420 | 0.02 |
| Roxithromycin | 3 | 2 | 1 | 3 | 0.82 | 954,837 | 0.03 |
| Etodolac | 3 | 3 | 0 | 4.33 | 0.47 | 1,356,200 | 0.02 |
| Dipyrone | 2 | 1 | 1 | 1.5 | 0.50 | NAa | NA |
| Vancomycin | 2 | 2 | 0 | 1.5 | 1.50 | NAb | NA |
| Bendamustine | 2 | 2 | 0 | 1 | 2.00 | 1660 | 12.05 |
| Carbamazepine | 2 | 1 | 1 | 5 | 1.00 | 61,789 | 0.32 |
| Ceftriaxone | 1 | 1 | 0 | 3 | NA | NAb | NA |
| Acyclovir | 1 | 0 | 1 | 2 | NA | 242,284 | 0.04 |
| Sulfasalazine | 1 | 1 | 0 | 6 | NA | 13,933 | 0.72 |
| Terbinafine | 1 | 1 | 0 | 3 | NA | 400,982 | 0.02 |
| Cefazolin | 1 | 1 | 0 | 2 or 4 | NA | NAb | NA |
| Macrogol | 1 | 0 | 1 | 1 | NA | 266,939 | 0.04 |
| Nitrofurantoin | 1 | 1 | 0 | 1 | NA | 351,227 | 0.03 |
| Pralatrexate | 1 | 1 | 0 | 1 | NA | 26 | 384.62 |
| Sunitinib | 1 | 1 | 0 | 4 | NA | 737 | 13.57 |
| Ibuprofen | 1 | 1 | 0 | −2 | NA | NAa | NA |
| Celecoxib | 1 | 1 | 0 | NA | NA | 273,590 | 0.04 |
| Topiramate | 1 | 1 | 0 | 3 | NA | 18,901 | 0.53 |
| Levomepromazine | 1 | 1 | 0 | 3 | NA | 11,490 | 0.87 |
| Quetiapine | 1 | 1 | 0 | 1 | NA | 19,999 | 0.50 |
| Citalopram | 1 | 1 | 0 | 0 | NA | 190,170 | 0.05 |
| Hydroxychloroquine | 1 | 1 | 0 | 3 | NA | 27,336 | 0.37 |
| Codeine | 1 | 1 | 0 | 1 | NA | 691,857 | 0.01 |
| Ofloxacin | 1 | 1 | 0 | −2 | NA | 446,280 | 0.02 |
| Carfilzomib | 1 | 0 | 1 | NA | NA | 452 | 22.12 |
| Cabozantinib | 1 | 1 | 0 | 3 | NA | 35 | 285.71 |
| Pregabalin | 1 | 1 | 0 | 0 | NA | 106,567 | 0.09 |
NA not available, OTC over-the-counter, SD standard deviation, SJS Stevens–Johnson syndrome, TEN toxic epidermal necrolysis
List of drugs by order of the total number of cases identified, along with mean ALDEN, and the frequency of occurrence of SJS/TEN per 10,000 adult new users of the drug. The list includes 2 optional culprit drugs for 14 patients and 3 optional culprit drugs for 2 patients
Culprit drug/s has not been identified during hospitalization, or discharge letters from hospitalization could not be reached in five of 87 valid cases, which are not represented in the table
ALDEN scores were calculated for 4 cases of etoricoxib and 3 cases of valproic acid, for which we had data available
aData of OTC drugs dispensing are not available in the database. Thus, total numbers of new users of these drugs are missing
bData of inpatient treatments are not available in the searchable database. Thus, total numbers of new users of these drugs are missing