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Severe cutaneous adverse reactions related to systemic antibiotics

Ying-Fang Lin1, Chih-Hsun Yang, Hu Sindy

  • 1Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|March 7, 2014
PubMed
Abstract

Insights

Systemic antibiotics can cause severe cutaneous adverse reactions (SCARs). Choosing alternative antibiotics is crucial for managing SCARs patients, especially those with infections, to prevent recurrence and improve outcomes.

Area of Science:

  • Dermatology
  • Pharmacology
  • Infectious Diseases

Background:

  • Systemic antibiotics are a significant cause of severe cutaneous adverse reactions (SCARs).
  • Managing SCARs patients with co-existing infections presents treatment challenges.
  • Identifying safe alternative antibiotics is critical for patient care.

Purpose of the Study:

  • To analyze antibiotic-induced SCARs in Taiwan.
  • To identify causative agents and clinical characteristics of SCARs.
  • To evaluate tolerability of alternative antibiotics in SCARs patients.

Main Methods:

  • Retrospective analysis of 74 SCARs cases (SJS, TEN, DRESS, AGEP) linked to systemic antibiotics (2006-2012).
  • Analysis of causative antibiotics, clinical presentations, organ involvement, and mortality rates.
  • Assessment of alternative antibiotic tolerability post-SCARs development.

Main Results:

  • Penicillins and cephalosporins were common causes for SJS/TEN and AGEP; glycopeptides for DRESS.
  • Higher mortality observed in Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) cases, especially with advanced age and sepsis.
  • Most patients tolerated quinolones, glycopeptides, and carbapenems after experiencing penicillin- or cephalosporin-induced SCARs.

Conclusions:

  • Complex infections and underlying conditions increase mortality risk in antibiotic-related SCARs.
  • Selecting structurally distinct alternative antibiotics is key to preventing SCARs recurrence.
  • Careful antibiotic selection is vital for managing patients with a history of SCARs.
Keywords:
SCARssystemic antibiotics

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