ZIEKENHUISOPNAMEN IN NEDERLAND VANWEGE ANAFYLAXIE DOOR GLAFENINE, 1987-1988

Objective. Estimation of the risk of anaphylaxis to glafenine. Design. A case cohort study. Location. All general and university hospitals in the Netherlands. Method. All admissions in 1987 and 1988 with anaphylaxis as the principal diagnosis, and a random sample of admissions with related symptoms were included. Hospital discharge summaries were classified according to probability of anaphylaxis by a blinded audit committee. Subsequently, of the cases of probable and possible anaphylaxis the causative agent was assessed. The reference cohort consisted of all persons in the catchment area of a sample of pharmacies in the Netherlands, in the same period. Results. Drug-induced anaphylaxis occurred in 107 patients: 20 were admitted because of anaphylaxis to glafenine (19%), 12 to amoxicillin (11%), 8 to diclofenac (7%) and 7 to preparations containing paracetamol (7%) of which 6 also contained propyphenazone (6%). Relative risk estimations showed that the risk of developing anaphylaxis to glafenine relative to all other drugs was 167.7 in 1987 (95% CI: 63.0-446.4) and 128.6 in 1988 (95% CI: 50.4-328.5) in the cases of probable anaphylaxis. Based on the number of prescriptions, the risk of developing anaphylaxis to glafenine was 16.8 relative to all penicillins (95% CI: 8.5-33.3) and 32.7 relative to all nonsteroidal antiinflammatory drugs (95% CI: 16.9-63.0). Conclusion. Based on the estimated incidence of anaphylaxis to penicillins of at least 1:10.000 prescriptions, the incidence of anaphylaxis to glafenine can be estimated at 1:1000 to 1:2000 prescriptions in the Netherlands.