Pharmacists' knowledge of allopurinol-induced Stevens-Johnson syndrome and its predictors: a study from Sudan.

Abstract

Objective: Stevens-Johnson syndrome (SJS) is a rare, life-threatening reaction often linked to allopurinol. Pharmacists are key in its prevention, but data on their knowledge in Sudan are limited. This study evaluated pharmacists' knowledge of allopurinol-induced SJS and its predictors.

Methods: This cross-sectional analytical study used a validated questionnaire and convenience sampling. The study was conducted among community pharmacists across Sudan between November and December 2023.

Key findings: A total of 385 pharmacists participated; 197 (51.2%) were male, and 188 (48.8%) were aged 20-25 years. The overall median knowledge score was 60% (IQR: 52-68%), with 310 (80.5%) demonstrating good knowledge. Awareness of the allopurinol-SJS association was reported by 246 (63.9%), but only 183 (47.5%) identified it as life-threatening. Misconceptions were common, as 228 (59.2%) believed the risk to be dose dependent. Female pharmacists (162/188, 86.2%) were more than twice as likely to have good knowledge (AOR = 2.06, 95% CI: 1.20-3.54; P = .009), whereas pharmacists having postgraduate degrees (59/61, 96.7%) were more than ten times as likely (AOR = 10.32, 95% CI: 2.17-49.01; P = .003). No significant associations were found with age, experience, or location.

Conclusion: Although most pharmacists displayed good overall knowledge, substantial gaps remain in recognizing the severity, causative factors, and genetic risks of allopurinol-induced SJS. Targeted education, pharmacovigilance training, and the integration of pharmacogenetics into pharmacy curricula are essential to improve early detection, patient counselling, and safe prescribing in Sudan.