title: Medications as risk factors of Stevens-Johnson syndrome and toxic epidermal necrolysis in children: a pooled analysis.
abstract: OBJECTIVE
  The aim of this study was to determine the relation of medications to the risk of Stevens-Johnson syndrome and toxic epidermal necrolysis in children <15 years of age.
  
  
  METHODS
  We conducted a pooled analysis by using data from 2 multicenter international case-control studies: the severe cutaneous adverse reaction (SCAR) study and the multinational severe cutaneous adverse reaction (EuroSCAR) study conducted in France, Germany, Italy, Portugal, the Netherlands, Austria, and Israel. We selected case subjects aged <15 years, hospitalized for Stevens-Johnson syndrome, Stevens-Johnson syndrome/toxic epidermal necrolysis-overlap, or toxic epidermal necrolysis, and age-, gender-, and country-matched hospital controls. Pooled crude odds ratios were estimated and adjusted for confounding by multivariate methods when numbers permitted.
  
  
  RESULTS
  Our study included 80 cases and 216 matched controls. Antiinfective sulfonamides, phenobarbital, carbamazepine, and lamotrigine were strongly associated with the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis. Significant associations were highlighted in univariate analysis for valproic acid and nonsteroidal antiinflammatory drugs as a group and for acetaminophen (paracetamol) in multivariate analysis.
  
  
  CONCLUSIONS
  We confirmed 4 previously highly suspected drug risk factors for Stevens-Johnson syndrome/toxic epidermal necrolysis in children: antiinfective sulfonamides, phenobarbital, carbamazepine, and lamotrigine. Among more unexpected risk factors, we suspect that acetaminophen (paracetamol) use increases the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis.
authors.affiliation: Service de Pharmacologie Clinique, Hôpital Henri Mondor Albert-Chenevier, Créteil, France.
authors.forename: Natacha
authors.initials: N
authors.lastname: Levi
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bastuji-Garin
authors.forename: Maja
authors.initials: M
authors.lastname: Mockenhaupt
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Roujeau
authors.forename: Antoine
authors.initials: A
authors.lastname: Flahault
authors.forename: Judith P
authors.initials: JP
authors.lastname: Kelly
authors.forename: Elvira
authors.initials: E
authors.lastname: Martin
authors.forename: David W
authors.initials: DW
authors.lastname: Kaufman
authors.forename: Patrick
authors.initials: P
authors.lastname: Maison
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012307:Risk Factors; D013262:Stevens-Johnson Syndrome / Q000139:chemically induced* / Q000453:epidemiology / Q000209:etiology*