Adverse cutaneous reactions to phenobarbital in epileptic children

Abstract

Introduction: Cutaneous adverse reaction to phenobarbital is not uncommon. According to previous studies, around 3 per cent of children taking phenobarbital have reactions. However, there has been no report in Thai children. Objective: To study adverse cutaneous reactions to phenobarbital in children with epilepsy. Patients and Method: A retrospective study from medical records of epileptic children aged under 15 years diagnosed at the Department of Pediatrics, Ramathibodi Hospital, Bangkok, Thailand from January 1989 to December 1993 was done. Adverse cutaneous reactions were categorized into 3 groups according to severity. Duration from the initiation of phenobarbital to the onset of reactions and the clinical course were collected for analysis. Result: There were 18 children from the total of 572-retrievable medical records of children with epilepsy who had adverse cutaneous reactions. The prevalence was 3.2%. There were 5, 10 and 3 patients categorized into mild-form, moderate-form, and severe form respectively. All except one patient had the onset of cutaneous reactions within 3 weeks. No morbidity or mortality was observed in these patients. Recovery of the cutaneous reactions was obtained between 5 and 14 days in those with mild or moderate form. Conclusion: Adverse cutaneous reactions to phenobarbital observed in Thai epileptic children were similar to those found in previous reports. Physicians who prescribe phenobarbital must be aware of the serious adverse reactions which might occur. Early recognition of the adverse reactions and prompt intervention including discontinuation of the drug must be exercised to prevent any serious complications.