article · International Journal of Risk & Safety in Medicine
Stevens-Johnson Syndrome is a rare, severe cutaneous reaction caused by adverse drug effects. Clinical and economic data concerning its management remain poorly documented in Gabon. An evaluation of four confirmed cases at the Libreville University Hospital Center reviewed patient outcomes linked respectively to lidocaine, allopurinol, amoxicillin combined with clavulanic acid, and flucloxacillin. Causality assessments conducted using the French causality method, the World Health Organisation scale, and the ALDEN algorithm confirmed probable drug causation in all four cases. Patients presented with SCORTEN severity scores between zero and one, correlating with an estimated mortality rate of 3.2 percent. Management relied entirely on supportive and symptomatic treatments, achieving favourable clinical outcomes for every patient. Direct medical costs averaged 225,089 CFA francs per patient, representing a substantial economic burden.
Stevens-Johnson Syndrome is a severe dermatological emergency triggered by common medications. Documenting its clinical presentation and management costs in Gabon provides vital baseline evidence on the local healthcare burden. These insights underline the necessity of strengthening national pharmacovigilance programmes and preventative clinical measures, helping clinicians identify adverse drug reactions early and avoid life-threatening complications in patients.
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BackgroundStevens-Johnson Syndrome (SJS) is a rare and severe drug-induced cutaneous reaction. However, clinical and economic data regarding its management remain poorly documented in Gabon. Therefore, this study aimed to describe the clinical characteristics, drug causality assessment, therapeutic management, and direct medical costs of four confirmed cases of SJS managed at the Libreville University Hospital Center (CHUL).Case reportFour confirmed cases of SJS related respectively to lidocaine, allopurinol, amoxicillin/clavulanic acid, and flucloxacillin were identified. Drug causality assessment, performed using the French causality assessment method, the World Health Organization (WHO) scale, and the ALDEN algorithm, indicated a probable causal relationship in all cases. SCORTEN scores ranged from 0 to 1, corresponding to an estimated mortality rate of 3.2%. Therapeutic management was based on symptomatic and supportive treatment, including Polaramine, Solumedrol, Dacryoserum, eosin solution, Fucithalmic, sodium bicarbonate, Fungizone, Dexeryl, ciprofloxacin, and Exomuc, with favorable clinical outcomes observed in all patients. The mean direct medical cost of management was estimated at 225,089 CFA francs (343.14 €), with a total cost of 860,355 CFA francs (1311.60 €) for the four cases.ConclusionSJS remains a severe dermatological emergency associated with substantial management costs despite favorable clinical outcomes. These findings highlight the importance of strengthening pharmacovigilance activities and the prevention of serious adverse drug reactions.
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DOI: 10.1177/09246479261479445
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