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

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

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.

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

MeSH terms

  • Age Factors
  • Anaphylaxis / etiology*
  • Anti-Bacterial Agents / adverse effects*
  • Asian People*
  • Carbapenems / adverse effects
  • Cephalosporins / adverse effects
  • Drug Therapy, Combination
  • Humans
  • Penicillins / adverse effects
  • Pharmacovigilance
  • Risk Factors
  • Sex Factors
  • Vietnam
  • beta-Lactams / adverse effects*

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Cephalosporins
  • Penicillins
  • beta-Lactams