Drug-Induced Anaphylaxis in a Vietnamese Pharmacovigilance Database: Trends and Specific Signals from a Disproportionality Analysis
Introduction Despite the numerous studies investigating drug-induced anaphylaxis (DIA), understanding and quantitative data analysis in developing countries remain limited. The aim of our study is to describe and quantify DIA using the National Pharmacovigilance Database of Vietnam (NPDV). Methods S...
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| Veröffentlicht in: | Drug safety 2019-05, Vol.42 (5), p.671-682 |
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| creator | Nguyen, Khac-Dung Nguyen, Hoang-Anh Vu, Dinh-Hoa Le, Thi Thuy-Linh Nguyen, Hoang-Anh Dang, Bich-Viet Nguyen, Trung-Nguyen Nguyen, Dang-Hoa Nguyen, Thanh-Binh Montastruc, Jean-Louis Bagheri, Haleh |
| description | Introduction
Despite the numerous studies investigating drug-induced anaphylaxis (DIA), understanding and quantitative data analysis in developing countries remain limited. The aim of our study is to describe and quantify DIA using the National Pharmacovigilance Database of Vietnam (NPDV).
Methods
Spontaneous reporting of adverse drug reactions (ADRs) recorded between 2010 and 2016 were retrospectively analysed to identify DIA reports. The trend and characteristics of DIA cases were described. Multivariate disproportionality analysis was used for signal generation.
Results
Overall, 4873 DIA cases (13.2% of total ADRs) were recorded in the NPDV, 111 of which resulted in death (82% of total ADR-induced deaths) over a 7-year period. There was a remarkable increase in DIA reporting over time (
p
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| doi_str_mv | 10.1007/s40264-018-0758-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2260026040</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2260026040</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-c7b98e7f16eb15c2726474a87a84783d4e881cca31241fc33eda0bb3c962ec4f3</originalsourceid><addsrcrecordid>eNp1kE1r3DAQhkVpabZJf0AvRdCzWn2tJecWskkbCDSQj6sYy-ONwlp2JLt0z_nj0bJpc8ppYHjmnZmHkC-Cfxecmx9Zc1lpxoVl3Cwts-_IQghTM1Fr-Z4suBCaLWtRHZBPOT9wzq2s7EdyoLg21kq1IE-rNK_ZRWxnjy09iTDebzfwN2QaIgV6F3CK0GNGenUPqQc__AnrsIHoka5gggYyHtObhLHNFGJLr0f0oQueXod1hE2mXRr6krQKeUzDOKQpDKUfpu1u22abQz4iH7pC4ueXekhuz89uTn-xy98_L05PLplXRk7Mm6a2aDpRYSOWXpryu9FgDdjyjWo1Wiu8ByWkFp1XClvgTaN8XUn0ulOH5Ns-txzyOGOe3MMwp92RTsqKF5dc80KJPeXTkHPCzo0p9JC2TnC30-722l3R7nbanS0zX1-S56bH9v_EP88FkHugSAhxjel19dupz26vjxY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2260026040</pqid></control><display><type>article</type><title>Drug-Induced Anaphylaxis in a Vietnamese Pharmacovigilance Database: Trends and Specific Signals from a Disproportionality Analysis</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Nguyen, Khac-Dung ; Nguyen, Hoang-Anh ; Vu, Dinh-Hoa ; Le, Thi Thuy-Linh ; Nguyen, Hoang-Anh ; Dang, Bich-Viet ; Nguyen, Trung-Nguyen ; Nguyen, Dang-Hoa ; Nguyen, Thanh-Binh ; Montastruc, Jean-Louis ; Bagheri, Haleh</creator><creatorcontrib>Nguyen, Khac-Dung ; Nguyen, Hoang-Anh ; Vu, Dinh-Hoa ; Le, Thi Thuy-Linh ; Nguyen, Hoang-Anh ; Dang, Bich-Viet ; Nguyen, Trung-Nguyen ; Nguyen, Dang-Hoa ; Nguyen, Thanh-Binh ; Montastruc, Jean-Louis ; Bagheri, Haleh</creatorcontrib><description>Introduction
Despite the numerous studies investigating drug-induced anaphylaxis (DIA), understanding and quantitative data analysis in developing countries remain limited. The aim of our study is to describe and quantify DIA using the National Pharmacovigilance Database of Vietnam (NPDV).
Methods
Spontaneous reporting of adverse drug reactions (ADRs) recorded between 2010 and 2016 were retrospectively analysed to identify DIA reports. The trend and characteristics of DIA cases were described. Multivariate disproportionality analysis was used for signal generation.
Results
Overall, 4873 DIA cases (13.2% of total ADRs) were recorded in the NPDV, 111 of which resulted in death (82% of total ADR-induced deaths) over a 7-year period. There was a remarkable increase in DIA reporting over time (
p
< 0.001). The incidence rates of DIA reporting per total ADRs and per 100,000 inhabitants remained high (mean rates [95% CI] of 12.06 [9.88–14.24] and 0.77 [0.33–1.20], respectively). Concerning suspected drugs, systemic antibiotics (
n
= 3318, 68%) were mostly reported with a reporting odds ratio (ROR) and 95% CI of 2.35 [2.20–2.51]. In the case of antibiotic-induced anaphylaxis, the third-generation cephalosporins were predominant (
n
= 1961, 40.2%, ROR 2.39 [2.24–2.55]). We also noted drugs generally associated with DIA such as contrast agents (ROR 2.43 [2.04–2.88]) and anaesthetics (ROR 4.02 [3.30–4.89]). Furthermore, unexpected signals were observed for alpha-chymotrypsin (ROR 1.75 [1.23–2.44]) and amoxicillin/sulbactam (ROR 1.59 [1.18–2.10]), uncommonly reported in western countries.
Conclusion
In recent years, cases of drug-induced DIA have increased in Vietnam, mostly due to antibiotics and third-generation cephalosporins. The inappropriate use of these drugs should be taken into account. Our findings also highlighted typical Vietnamese signals for alpha-chymotrypsin- and amoxicillin/sulbactam-induced anaphylaxis, which may relate to a specific sociological context in resource-limited countries.</description><identifier>ISSN: 0114-5916</identifier><identifier>EISSN: 1179-1942</identifier><identifier>DOI: 10.1007/s40264-018-0758-8</identifier><identifier>PMID: 30478823</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adverse Drug Reaction Reporting Systems ; Allergies ; Amoxicillin ; Anaphylaxis ; Anaphylaxis - epidemiology ; Anesthetics ; Antibiotics ; Causality ; Cephalosporins ; Chymotrypsin ; Contrast agents ; Data analysis ; Databases, Factual ; Developing countries ; Drug Safety and Pharmacovigilance ; Drugs ; Epidemiology ; Humans ; Immunology ; LDCs ; Medicine ; Medicine & Public Health ; Original Research Article ; Patients ; Pharmaceutical industry ; Pharmacology ; Pharmacology/Toxicology ; Pharmacovigilance ; Side effects ; Signal generation ; Studies ; Sulbactam ; Trends ; Vietnam - epidemiology</subject><ispartof>Drug safety, 2019-05, Vol.42 (5), p.671-682</ispartof><rights>Springer Nature Switzerland AG 2018</rights><rights>Copyright Springer Nature B.V. May 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-c7b98e7f16eb15c2726474a87a84783d4e881cca31241fc33eda0bb3c962ec4f3</citedby><cites>FETCH-LOGICAL-c372t-c7b98e7f16eb15c2726474a87a84783d4e881cca31241fc33eda0bb3c962ec4f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40264-018-0758-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40264-018-0758-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30478823$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nguyen, Khac-Dung</creatorcontrib><creatorcontrib>Nguyen, Hoang-Anh</creatorcontrib><creatorcontrib>Vu, Dinh-Hoa</creatorcontrib><creatorcontrib>Le, Thi Thuy-Linh</creatorcontrib><creatorcontrib>Nguyen, Hoang-Anh</creatorcontrib><creatorcontrib>Dang, Bich-Viet</creatorcontrib><creatorcontrib>Nguyen, Trung-Nguyen</creatorcontrib><creatorcontrib>Nguyen, Dang-Hoa</creatorcontrib><creatorcontrib>Nguyen, Thanh-Binh</creatorcontrib><creatorcontrib>Montastruc, Jean-Louis</creatorcontrib><creatorcontrib>Bagheri, Haleh</creatorcontrib><title>Drug-Induced Anaphylaxis in a Vietnamese Pharmacovigilance Database: Trends and Specific Signals from a Disproportionality Analysis</title><title>Drug safety</title><addtitle>Drug Saf</addtitle><addtitle>Drug Saf</addtitle><description>Introduction
Despite the numerous studies investigating drug-induced anaphylaxis (DIA), understanding and quantitative data analysis in developing countries remain limited. The aim of our study is to describe and quantify DIA using the National Pharmacovigilance Database of Vietnam (NPDV).
Methods
Spontaneous reporting of adverse drug reactions (ADRs) recorded between 2010 and 2016 were retrospectively analysed to identify DIA reports. The trend and characteristics of DIA cases were described. Multivariate disproportionality analysis was used for signal generation.
Results
Overall, 4873 DIA cases (13.2% of total ADRs) were recorded in the NPDV, 111 of which resulted in death (82% of total ADR-induced deaths) over a 7-year period. There was a remarkable increase in DIA reporting over time (
p
< 0.001). The incidence rates of DIA reporting per total ADRs and per 100,000 inhabitants remained high (mean rates [95% CI] of 12.06 [9.88–14.24] and 0.77 [0.33–1.20], respectively). Concerning suspected drugs, systemic antibiotics (
n
= 3318, 68%) were mostly reported with a reporting odds ratio (ROR) and 95% CI of 2.35 [2.20–2.51]. In the case of antibiotic-induced anaphylaxis, the third-generation cephalosporins were predominant (
n
= 1961, 40.2%, ROR 2.39 [2.24–2.55]). We also noted drugs generally associated with DIA such as contrast agents (ROR 2.43 [2.04–2.88]) and anaesthetics (ROR 4.02 [3.30–4.89]). Furthermore, unexpected signals were observed for alpha-chymotrypsin (ROR 1.75 [1.23–2.44]) and amoxicillin/sulbactam (ROR 1.59 [1.18–2.10]), uncommonly reported in western countries.
Conclusion
In recent years, cases of drug-induced DIA have increased in Vietnam, mostly due to antibiotics and third-generation cephalosporins. The inappropriate use of these drugs should be taken into account. Our findings also highlighted typical Vietnamese signals for alpha-chymotrypsin- and amoxicillin/sulbactam-induced anaphylaxis, which may relate to a specific sociological context in resource-limited countries.</description><subject>Adverse Drug Reaction Reporting Systems</subject><subject>Allergies</subject><subject>Amoxicillin</subject><subject>Anaphylaxis</subject><subject>Anaphylaxis - epidemiology</subject><subject>Anesthetics</subject><subject>Antibiotics</subject><subject>Causality</subject><subject>Cephalosporins</subject><subject>Chymotrypsin</subject><subject>Contrast agents</subject><subject>Data analysis</subject><subject>Databases, Factual</subject><subject>Developing countries</subject><subject>Drug Safety and Pharmacovigilance</subject><subject>Drugs</subject><subject>Epidemiology</subject><subject>Humans</subject><subject>Immunology</subject><subject>LDCs</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Research Article</subject><subject>Patients</subject><subject>Pharmaceutical industry</subject><subject>Pharmacology</subject><subject>Pharmacology/Toxicology</subject><subject>Pharmacovigilance</subject><subject>Side effects</subject><subject>Signal generation</subject><subject>Studies</subject><subject>Sulbactam</subject><subject>Trends</subject><subject>Vietnam - epidemiology</subject><issn>0114-5916</issn><issn>1179-1942</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kE1r3DAQhkVpabZJf0AvRdCzWn2tJecWskkbCDSQj6sYy-ONwlp2JLt0z_nj0bJpc8ppYHjmnZmHkC-Cfxecmx9Zc1lpxoVl3Cwts-_IQghTM1Fr-Z4suBCaLWtRHZBPOT9wzq2s7EdyoLg21kq1IE-rNK_ZRWxnjy09iTDebzfwN2QaIgV6F3CK0GNGenUPqQc__AnrsIHoka5gggYyHtObhLHNFGJLr0f0oQueXod1hE2mXRr6krQKeUzDOKQpDKUfpu1u22abQz4iH7pC4ueXekhuz89uTn-xy98_L05PLplXRk7Mm6a2aDpRYSOWXpryu9FgDdjyjWo1Wiu8ByWkFp1XClvgTaN8XUn0ulOH5Ns-txzyOGOe3MMwp92RTsqKF5dc80KJPeXTkHPCzo0p9JC2TnC30-722l3R7nbanS0zX1-S56bH9v_EP88FkHugSAhxjel19dupz26vjxY</recordid><startdate>20190501</startdate><enddate>20190501</enddate><creator>Nguyen, Khac-Dung</creator><creator>Nguyen, Hoang-Anh</creator><creator>Vu, Dinh-Hoa</creator><creator>Le, Thi Thuy-Linh</creator><creator>Nguyen, Hoang-Anh</creator><creator>Dang, Bich-Viet</creator><creator>Nguyen, Trung-Nguyen</creator><creator>Nguyen, Dang-Hoa</creator><creator>Nguyen, Thanh-Binh</creator><creator>Montastruc, Jean-Louis</creator><creator>Bagheri, Haleh</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7RV</scope><scope>7T2</scope><scope>7TK</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20190501</creationdate><title>Drug-Induced Anaphylaxis in a Vietnamese Pharmacovigilance Database: Trends and Specific Signals from a Disproportionality Analysis</title><author>Nguyen, Khac-Dung ; Nguyen, Hoang-Anh ; Vu, Dinh-Hoa ; Le, Thi Thuy-Linh ; Nguyen, Hoang-Anh ; Dang, Bich-Viet ; Nguyen, Trung-Nguyen ; Nguyen, Dang-Hoa ; Nguyen, Thanh-Binh ; Montastruc, Jean-Louis ; Bagheri, Haleh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-c7b98e7f16eb15c2726474a87a84783d4e881cca31241fc33eda0bb3c962ec4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adverse Drug Reaction Reporting Systems</topic><topic>Allergies</topic><topic>Amoxicillin</topic><topic>Anaphylaxis</topic><topic>Anaphylaxis - epidemiology</topic><topic>Anesthetics</topic><topic>Antibiotics</topic><topic>Causality</topic><topic>Cephalosporins</topic><topic>Chymotrypsin</topic><topic>Contrast agents</topic><topic>Data analysis</topic><topic>Databases, Factual</topic><topic>Developing countries</topic><topic>Drug Safety and Pharmacovigilance</topic><topic>Drugs</topic><topic>Epidemiology</topic><topic>Humans</topic><topic>Immunology</topic><topic>LDCs</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Research Article</topic><topic>Patients</topic><topic>Pharmaceutical industry</topic><topic>Pharmacology</topic><topic>Pharmacology/Toxicology</topic><topic>Pharmacovigilance</topic><topic>Side effects</topic><topic>Signal generation</topic><topic>Studies</topic><topic>Sulbactam</topic><topic>Trends</topic><topic>Vietnam - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nguyen, Khac-Dung</creatorcontrib><creatorcontrib>Nguyen, Hoang-Anh</creatorcontrib><creatorcontrib>Vu, Dinh-Hoa</creatorcontrib><creatorcontrib>Le, Thi Thuy-Linh</creatorcontrib><creatorcontrib>Nguyen, Hoang-Anh</creatorcontrib><creatorcontrib>Dang, Bich-Viet</creatorcontrib><creatorcontrib>Nguyen, Trung-Nguyen</creatorcontrib><creatorcontrib>Nguyen, Dang-Hoa</creatorcontrib><creatorcontrib>Nguyen, Thanh-Binh</creatorcontrib><creatorcontrib>Montastruc, Jean-Louis</creatorcontrib><creatorcontrib>Bagheri, Haleh</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Nursing & Allied Health Database</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Drug safety</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nguyen, Khac-Dung</au><au>Nguyen, Hoang-Anh</au><au>Vu, Dinh-Hoa</au><au>Le, Thi Thuy-Linh</au><au>Nguyen, Hoang-Anh</au><au>Dang, Bich-Viet</au><au>Nguyen, Trung-Nguyen</au><au>Nguyen, Dang-Hoa</au><au>Nguyen, Thanh-Binh</au><au>Montastruc, Jean-Louis</au><au>Bagheri, Haleh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Drug-Induced Anaphylaxis in a Vietnamese Pharmacovigilance Database: Trends and Specific Signals from a Disproportionality Analysis</atitle><jtitle>Drug safety</jtitle><stitle>Drug Saf</stitle><addtitle>Drug Saf</addtitle><date>2019-05-01</date><risdate>2019</risdate><volume>42</volume><issue>5</issue><spage>671</spage><epage>682</epage><pages>671-682</pages><issn>0114-5916</issn><eissn>1179-1942</eissn><abstract>Introduction
Despite the numerous studies investigating drug-induced anaphylaxis (DIA), understanding and quantitative data analysis in developing countries remain limited. The aim of our study is to describe and quantify DIA using the National Pharmacovigilance Database of Vietnam (NPDV).
Methods
Spontaneous reporting of adverse drug reactions (ADRs) recorded between 2010 and 2016 were retrospectively analysed to identify DIA reports. The trend and characteristics of DIA cases were described. Multivariate disproportionality analysis was used for signal generation.
Results
Overall, 4873 DIA cases (13.2% of total ADRs) were recorded in the NPDV, 111 of which resulted in death (82% of total ADR-induced deaths) over a 7-year period. There was a remarkable increase in DIA reporting over time (
p
< 0.001). The incidence rates of DIA reporting per total ADRs and per 100,000 inhabitants remained high (mean rates [95% CI] of 12.06 [9.88–14.24] and 0.77 [0.33–1.20], respectively). Concerning suspected drugs, systemic antibiotics (
n
= 3318, 68%) were mostly reported with a reporting odds ratio (ROR) and 95% CI of 2.35 [2.20–2.51]. In the case of antibiotic-induced anaphylaxis, the third-generation cephalosporins were predominant (
n
= 1961, 40.2%, ROR 2.39 [2.24–2.55]). We also noted drugs generally associated with DIA such as contrast agents (ROR 2.43 [2.04–2.88]) and anaesthetics (ROR 4.02 [3.30–4.89]). Furthermore, unexpected signals were observed for alpha-chymotrypsin (ROR 1.75 [1.23–2.44]) and amoxicillin/sulbactam (ROR 1.59 [1.18–2.10]), uncommonly reported in western countries.
Conclusion
In recent years, cases of drug-induced DIA have increased in Vietnam, mostly due to antibiotics and third-generation cephalosporins. The inappropriate use of these drugs should be taken into account. Our findings also highlighted typical Vietnamese signals for alpha-chymotrypsin- and amoxicillin/sulbactam-induced anaphylaxis, which may relate to a specific sociological context in resource-limited countries.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>30478823</pmid><doi>10.1007/s40264-018-0758-8</doi><tpages>12</tpages></addata></record> |
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| ispartof | Drug safety, 2019-05, Vol.42 (5), p.671-682 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adverse Drug Reaction Reporting Systems Allergies Amoxicillin Anaphylaxis Anaphylaxis - epidemiology Anesthetics Antibiotics Causality Cephalosporins Chymotrypsin Contrast agents Data analysis Databases, Factual Developing countries Drug Safety and Pharmacovigilance Drugs Epidemiology Humans Immunology LDCs Medicine Medicine & Public Health Original Research Article Patients Pharmaceutical industry Pharmacology Pharmacology/Toxicology Pharmacovigilance Side effects Signal generation Studies Sulbactam Trends Vietnam - epidemiology |
| title | Drug-Induced Anaphylaxis in a Vietnamese Pharmacovigilance Database: Trends and Specific Signals from a Disproportionality Analysis |
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