Incidence and risk factors for cutaneous adverse drug reactions in an intensive care unit.

OBJECTIVE To evaluate the incidence of adverse cutaneous drug reactions in intensive care unit patients. DESIGN Cohort study. SETTING General adult intensive care unit of an institutional tertiary care hospital. PATIENTS Patients in the intensive care unit during a consecutive 8-month period were examined for adverse cutaneous drug reactions. RESULTS Patients in the intensive care unit have an incidence of 11.6% of adverse cutaneous drug reactions. Associated risk factors were female gender, obesity, age over 60 and immune dysregulation (systemic lupus erythematosus, dysthyroidism, and antiphospholipid antibodies syndrome). Few patients had previous history of adverse cutaneous drug reactions. Antimicrobials were the main drug involved. Morbilliform rash followed by urticary were the most frequently observed reactions. Interestingly, over 50% of patients with massive edema -independent of etiology- died. CONCLUSIONS Intensive care unit patients are particularly at risk for developing an adverse cutaneous drug reaction.