Introduction: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe adverse drug reaction characterized by skin rash, visceral organ involvement, and hematologic abnormalities. This study analyzes DRESS-related adverse events reported in the FDA FAERS database to identify age-specific patterns and associated drugs.

Method: A total of 21,488 DRESS-related adverse event reports with available age data in the FAERS database (2003–2024) were analyzed, focusing on gender, children and adult age group (0-17 and ≥18 age years, respectively), and reaction severity. The drugs mentioned in these reports were categorized using ATC codes for both age groups.

Results: Of the 21,488 cases analyzed, 52.0% of the patients were female in both age groups. The mean age was 10.4 ± 5.2 years in the children and 54.4 ± 18.4 years in the adult group. Serious events accounted for 99.7% of all reported cases, and 6.8% resulted in death. DRESS was the sole reported reaction in 8,597 cases (40.0%). Among the reports, 9,831 (45.8%) involved a single suspected active ingredient. The children accounted for 11.4% of the cases, and 10.0% of the 56,327 reported drugs were included in reports related to this age group. The most frequently suspected active ingredients in children were lamotrigine (7.3%), carbamazepine (4.2%), vancomycin (3.8%), co- trimoxazole (3.3%), and levetiracetam (3.2%). In adults, the most frequently suspected active ingredients were allopurinol (5.6%), vancomycin (3.3%), lamotrigine (3.3%), co- trimoxazole (2.6%), and carbamazepine (2.3%).

Conclusion: Our analysis of FAERS data highlights age-specific patterns in DRESS- related adverse events, with antiepileptics prominent in both age groups and allopurinol leading in adults. The high rate of serious outcomes, including death, underscores the need for targeted risk minimization strategies across age groups.