The aim of the study was to evaluate the pattern of utilization of systemic drugs used in the management of adverse drug reactions (ADRs) leading to hospitalization. A prospective pharmacovigilance study was carried out among patients admitted to the Clinic of Dermatology and Venereology in Stara Zagora (July 1999–June 2009). ADRs were classified by type, severity and causality. Casecausality was scored according to Naranjo et al. (1981). Drug utilization was measured in defined daily doses (DDDs) per 100 hospital bed days. A total of 144 cutaneous ADRs, predominantly “type B” were the reason for hospitalization. Highest utilization for the management of ADRs was found for the drug groups “Blood and blood forming organs” (406.08 DDDs/100 bed days) and “Respiratory system” (111.15 DDDs/100 bed days). The use of DDD for measuring drug utilization reveals the importance of drug-induced exacerbations of chronic skin diseases like psoriasis which were associated with significant utilization of drugs belonging to the group “Blood and blood forming organs”. Considering the low preventability of “type B” ADRs, our findings suggest that potential reduction of drug-related hospitalizations may be achieved through the rational use of drugs in patients with comorbidities.