PDF(Pubmed)
Abstract：
UNASSIGNED: Severe cutaneous adverse reactions (SCARs) are rare but life-threatening, with antibiotics being the main cause. This retrospective study from a single center was designed to analyze the culprit drugs, clinical features and treatment outcomes of antibiotic-induced SCARs.
UNASSIGNED: We analyzed cases of antibiotic-induced SCARs in a tertiary hospital in China between January 2013 and January 2024, including Steven-Johnson syndrome (SJS) or Stevens-Johnson syndrome-toxic epidermal necrolysis (SJS-TEN) overlap, toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS) and acute generalized exanthematous pustulosis (AGEP). Descriptive analysis of the demographic characteristics, clinical manifestations, treatment and prognosis were carried out.
UNASSIGNED: Among 354 cases of SCARs, 63 validated antibiotic-related cases were included. Cephalosporins (31.7%), penicillins (25.4%), and quinolones (19.0%) were the most common triggers for SCARs. Overall, liver (50.8%), lungs (31.7%), and kidneys (23.8%) were the most frequently affected organ in SCARs cases. Eight patients (28.6%) in the SJS/SJS-TEN overlap group and 8 patients (80.0%) in the TEN group received combination therapy of corticosteroids and IVIG. Patients with SCARs caused by penicillins or cephalosporins could receive alternative treatments such as lincomamides, quinolones, and tetracyclines. The mortality rate in the TEN group was the highest at 20.0%, followed by the SJS/SJS-TEN overlap group (7.1%), and no deaths were observed in the DRESS and AGEP groups.
UNASSIGNED: The identification of the culprit antibiotics and the application of alternative antibiotic therapies are crucial for the management of antibiotic-induced SCARs. If complicated underlying conditions and complications like advanced age, cancer and pneumonia coexist with SCARs, patients might be more at risk for mortality.
UNASSIGNED: We analyzed cases of antibiotic-induced SCARs in a tertiary hospital in China between January 2013 and January 2024, including Steven-Johnson syndrome (SJS) or Stevens-Johnson syndrome-toxic epidermal necrolysis (SJS-TEN) overlap, toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS) and acute generalized exanthematous pustulosis (AGEP). Descriptive analysis of the demographic characteristics, clinical manifestations, treatment and prognosis were carried out.
UNASSIGNED: Among 354 cases of SCARs, 63 validated antibiotic-related cases were included. Cephalosporins (31.7%), penicillins (25.4%), and quinolones (19.0%) were the most common triggers for SCARs. Overall, liver (50.8%), lungs (31.7%), and kidneys (23.8%) were the most frequently affected organ in SCARs cases. Eight patients (28.6%) in the SJS/SJS-TEN overlap group and 8 patients (80.0%) in the TEN group received combination therapy of corticosteroids and IVIG. Patients with SCARs caused by penicillins or cephalosporins could receive alternative treatments such as lincomamides, quinolones, and tetracyclines. The mortality rate in the TEN group was the highest at 20.0%, followed by the SJS/SJS-TEN overlap group (7.1%), and no deaths were observed in the DRESS and AGEP groups.
UNASSIGNED: The identification of the culprit antibiotics and the application of alternative antibiotic therapies are crucial for the management of antibiotic-induced SCARs. If complicated underlying conditions and complications like advanced age, cancer and pneumonia coexist with SCARs, patients might be more at risk for mortality.
摘要：
■严重的皮肤不良反应（SCAR）是罕见的，但危及生命，抗生素是主要原因。这项来自单一中心的回顾性研究旨在分析罪魁祸首药物，抗生素诱导的SCAR的临床特征和治疗结果。
我们分析了2013年1月至2024年1月间中国某三甲医院抗生素诱发的SCAR病例，包括史蒂文-约翰逊综合征（SJS）或史蒂文斯-约翰逊综合征-中毒性表皮坏死松解症（SJS-TEN）重叠，中毒性表皮坏死松解症（TEN），药物反应伴嗜酸性粒细胞增多和全身症状（DRESS）和急性全身性发疹性脓疱病（AGEP）。对人口特征的描述性分析，临床表现，进行治疗和预后。
■在354例SCAR中，纳入63例经过验证的抗生素相关病例。头孢菌素（31.7％），青霉素（25.4%），喹诺酮类药物(19.0%)是SCAR最常见的触发因素。总的来说,肝脏（50.8%），肺（31.7％），在SCAR病例中，肾脏(23.8%)是最常见的受累器官。SJS/SJS-TEN重叠组8例(28.6%)和TEN组8例(80.0%)接受糖皮质激素和IVIG联合治疗。由青霉素或头孢菌素引起的SCAR患者可以接受替代疗法，例如林可胺，喹诺酮类药物,还有四环素.TEN组死亡率最高,为20.0%,其次是SJS/SJS-TEN重叠组(7.1%)，在DRESS和AGEP组中没有观察到死亡。
■识别罪魁祸首抗生素和应用替代抗生素疗法对于抗生素诱导的SCAR的管理至关重要。如果复杂的潜在疾病和并发症，如高龄，癌症和肺炎与SCAR并存，患者可能面临更大的死亡风险。
我们分析了2013年1月至2024年1月间中国某三甲医院抗生素诱发的SCAR病例，包括史蒂文-约翰逊综合征（SJS）或史蒂文斯-约翰逊综合征-中毒性表皮坏死松解症（SJS-TEN）重叠，中毒性表皮坏死松解症（TEN），药物反应伴嗜酸性粒细胞增多和全身症状（DRESS）和急性全身性发疹性脓疱病（AGEP）。对人口特征的描述性分析，临床表现，进行治疗和预后。
■在354例SCAR中，纳入63例经过验证的抗生素相关病例。头孢菌素（31.7％），青霉素（25.4%），喹诺酮类药物(19.0%)是SCAR最常见的触发因素。总的来说,肝脏（50.8%），肺（31.7％），在SCAR病例中，肾脏(23.8%)是最常见的受累器官。SJS/SJS-TEN重叠组8例(28.6%)和TEN组8例(80.0%)接受糖皮质激素和IVIG联合治疗。由青霉素或头孢菌素引起的SCAR患者可以接受替代疗法，例如林可胺，喹诺酮类药物,还有四环素.TEN组死亡率最高,为20.0%,其次是SJS/SJS-TEN重叠组(7.1%)，在DRESS和AGEP组中没有观察到死亡。
■识别罪魁祸首抗生素和应用替代抗生素疗法对于抗生素诱导的SCAR的管理至关重要。如果复杂的潜在疾病和并发症，如高龄，癌症和肺炎与SCAR并存，患者可能面临更大的死亡风险。
