title: Inadequate drug prescription and the rise in drug-induced acute tubulointerstitial nephritis incidence.
abstract: Drugs are a frequent cause of acute tubulointerstitial nephritis (ATIN). Antibiotics, non-steroidal anti-inflammatory drugs and recently proton pump inhibitors stand among the most commonly responsible ones. However, their respective responsibility is not well known. This study reports 33 cases of drug-induced ATIN (DI-ATIN), the most frequent ones being metamizole and omeprazole. Clinicians often fail to diagnose DI-ATIN because its signs and symptoms are non-specific and differ from the now classic form observed with methicillin. Furthermore, drugs causing ATIN are too often prescribed unnecessarily. This study shows that in more than one-fifth of our cases, ATIN complicated prescription of a drug that was not justified by an adequate clinical indication. The consequences were noxious for the patients and costly in terms of public health expenses.
authors.affiliation: Basque Country Pharmacovigilance Unit, Galdakao-Usansolo Hospital , Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Garcia
authors.affiliation: Nephrology Division, Santiago Hospital , Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Saracho
authors.affiliation: Pharmacy Unit, Basque Health Service , Spain.
authors.forename: Nekane
authors.initials: N
authors.lastname: Jaio
authors.affiliation: Research Unit, Galdakao-Usansolo Hospital , Spain.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Vrotsoukanari
authors.affiliation: Basque Country Pharmacovigilance Unit, Galdakao-Usansolo Hospital , University of the Basque Country , School of Medicine, Pharmacology , Spain.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Aguirre
keywords: NSAIDs; acute tubulointerstitial nephritis; incidence; proton pump inhibitors