PREVALENCE OF ADVERSE CUTANEOUS DRUG REACTIONS IN PATIENTS RECEIVING NSAIDS IN RSUP DR. SARDJITO YOGYAKARTA IN 2015-2017

DIGITA NATARINA Y, dr. Fajar Waskito, Sp.KK(K), M.KeS;Dr. dr. Rustamaji, M.Kes

2018 | Skripsi | S1 KEDOKTERAN

Latar Belakang: Adverse Cutaneous Drug Reactions (ACDRs) didefinisikan sebagai perubahan yang tidak diinginkan dalam struktur kulit, termasuk semua efek samping yang terkait dengan erupsi obat. NSAIDs adalah obat yang paling umum digunakan di seluruh dunia dam dikenal sebagai penyebab reaksi obat yang merugikan secara umum. Namun, epidemiologi ACDRs dengan hipersensitivitas tipe IV yang dicurigai karena NSAIDs belum diselidiki di Yogyakarta. Tujuan: Penelitian ini bertujuan untuk mengetahui prevalensi ACDRs dicurigai akibat obat NSAIDs di Dermatologi dan Venerologi poliklinik rawat inap dan jalan di RSUP Dr. Sardjito periode 2015- 2017 Metode. Menerapkan studi retrospektif-observasional dengan desain cross-sectional, penelitian ini menggunakan data rekam medis periode tahun 2015-2017. Data dianalisis menggunakan pendekatan deskriptif termasuk data demografi pasien seperti usia, jenis kelamin, komorbiditas, NSAIDs obat dan gambaran klinis ACDRs. Hasil. Dari total 50 kasus ACDRs dengan tipe IV hipersensitivitas dicurigai akibat obat NSAIDs terlihat di antara 15.711 pasien, menghasilkan prevalensi 0,32%. Usia rata-rata pasien adalah 39,36 �± 15,62 tahun. Rentang usia 5-76 tahun. Sebagian besar dari subjek (56%) berada di kelompok usia 35-60 tahun (dewasa tengah). Rasio perempuan dan laki-laki adalah 1,5: 1. Komorbiditas utama adalah HIV-AIDS (10%); tuberkulosis (10%); dan keduanya (4%). Agen penyebab yang paling umum adalah parasetamol (46,6%), diikuti oleh asam mefenamat (27,6%), diklofenak (10,3%), ibuprofen (12,1%), meloxicam (1,7%), dan aspirin (1,17%). Erupsi makulopapular adalah manifestasi klinis yang paling umum. Kesimpulan. Prevalensi ACDRs dengan hipersensitivitas tipe IV yang dicurigai akibat obat NSAID di poliklinik rawat inap dan jalan di RSUP Sardjito pada periode 2015-2017 adalah 0,32% dengan obat yang mendasari yang paling umum menyebabkan erupsi adalah parasetamol, diikuti oleh asam mefenamat, diklofenak, ibuprofen, meloxicam, dan aspirin.

Background: Adverse cutaneous drug reactions (ACDRs) are defined as undesirable change in the skin structure and it includes all adverse events related to drug eruption. NSAIDs are the most prevalent used drugs worldwide and well-recognized as a cause of drug eruption in general. However, epidemiology of ACDRs with type IV hypersensitivity suspected due to NSAIDs has not been investigated yet in Yogyakarta. Objective: This study aims to find out the prevalence of ACDRs suspected due to NSAIDs in the Dermatology and Venereology in-patient and out-patient clinics RSUP Dr. Sardjito period 2015-2017 Method: Applying retrospective-observational study with cross-sectional design, the study was undertaken by collecting medical record data over the period of 2015-2017. The data were analysed using a descriptive approach includes demographical data of the patient such as age, sex, comorbidity, NSAIDs drugs and the clinical features of ACDRs Result: From total of 50 cases of ACDRs with type IV hypersensitivity suspected due to NSAIDs were seen among 15.711 patients, yielding a prevalence of 0,32%. The mean age of the patients was 39,36�±15,62 years. The age range was 5-76 years. Most of them (56%) were in the age group of 35-60 years (middle adulthood). The female to male ratio was 1,5: 1. The main comorbidities were HIV-AIDS (10%); tuberculosis (10%); and both of them (4%). The most common causative agents were paracetamol (46,6%), followed by mefenamic acid (27,6%), diclofenac (10,3%), ibuprofen (12,1%), meloxicam (1,7%), and aspirin (1,17%). Maculopapular eruption was the most common of clinical manifestations. Conclusion: Prevalence of ACDRs with type IV hypersensitivity suspected due to NSAIDs drugs in DV in-patient and out-patient clinics in RSUP Sardjito in the period of 2015-2017 was 0,32% with the most common suspected drugs causing eruptions were paracetamol, followed by mefenamic acid, diclofenac, ibuprofen, meloxicam, and aspirin.

Kata Kunci : Nonsteroidal anti-inflammatory drugs, NSAIDs, Adverse Cutaneous Drug Reactions, ACDRs