Unveiling the impact of traditional Chinese herbal medicines on cutaneous adverse drug reactions: A landmark 15-year nationwide study.

Background: Traditional Chinese herbal medicines (TCMs) have become increasingly integrated into global healthcare systems, often used alongside conventional pharmaceuticals. While TCMs offer therapeutic benefits, their concomitant use with other medications raises concerns over cutaneous adverse drug reactions (CADRs). Despite the widespread use of TCMs, large-scale studies examining their safety in combination with antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) remain limited.

Objective: This study aimed to analyze the frequency and severity of CADRs associated with TCMs, focusing on their interactions with antibiotics and NSAIDs in a comprehensive dataset spanning over 15 years in China.

Methods: We retrospectively reviewed clinical data from over 1.8 million patient visits annually between 2007 and 2022. Both mild and severe CADRs (SCARs) associated with TCMs, antibiotics, and NSAIDs were evaluated.

Results: While used in combination with antibiotics or NSAIDs, TCMs did not significantly increase the incidence of SCARs, although TCMs, antibiotics, or NSAIDs accounted for a proportion of CADRs. In contrast, the combination of antibiotics with NSAIDs showed a higher frequency of SCARs compared to monotherapy. These results suggest that TCMs have a favorable safety profile in multi-drug regimens, but careful monitoring is essential, particularly in multi-drug therapies involving conventional medications.

Conclusion: This groundbreaking study provides unprecedented insights into the role of TCMs in CADRs, highlighting their potential for safer integration into multi-drug regimens. Although TCMs did not exacerbate the risk of severe reactions when combined with antibiotics or NSAIDs, vigilance in drug safety protocols remains crucial. These findings support the cautious and well-regulated use of TCMs within broader healthcare frameworks, promoting their safe integration alongside conventional therapies.