One Case of Toxic Epidermal Necrolysis Induced by Antibacterial Drugs
LUO Xiaofeng1, DU Qian2, XI Xin2, RAN Hailong2,*
1School of Pharmacy, Chongqing Medical University, Chongqing 400016, China; 2Department of Pharmacy, the Third Affiliated Hospital of Chongqing Medical University(Gener Hospital), Chongqing 401120, China
Abstract:Objective To remind the medical staff to pay close attention to medication safety of antibacterial drugs. Methods One case of toxic epidermal necrolysis (TEN) after intravenous infusion of piperacillin tazobactam, imipenem/cilastatin, and levofloxacin in a 45-year-old male patient was analyzed while literature about the pathogenesis and treatment of TEN was reviewed. Results Toxic epidermal necrolysis was most likely to be induced by piperacillin tazobactam, imipenem/cilastatin, and levofloxacin in this patient. The symptoms on the patient's skin were relieved gradually via timely discontinuation of the drugs, anti-allergic therapy, systemic immunotherapy, and symptomatic supportive treatment. Conclusion Toxic epidermal necrolysis induced by piperacillin tazobactam, imipenem/cilastatin, and levofloxacin is a disease with low incidence, but with a high mortality and poor prognosis, which deserves attention.
罗晓枫, 杜倩, 奚鑫, 冉海龙. 抗菌药物致中毒性表皮坏死松解症1例[J]. 中国药物警戒, 2020, 17(8): 535-538.
LUO Xiaofeng, DU Qian, XI Xin, RAN Hailong. One Case of Toxic Epidermal Necrolysis Induced by Antibacterial Drugs. Chinese Journal of Pharmacovigilance, 2020, 17(8): 535-538.
[1] 袁静, 李福民. 中毒性表皮坏死松解症和Stevens-Johnson综合征[J]. 实用医院临床杂志, 2012, 9(4):207-209. [2] 吴晓燕, 瞿发林. 中毒性表皮坏死松解症的致病药物及防治体会[J]. 实用药物与临床, 2012, 15(5):304-306. [3] Digwood-Lettieri S, Reilly KJ, Haith LR, et al.Levofloxacin-induced toxic epidermal necrolysis in an elderly patient[J].Pharmacotherapy,2002, 22(6):789-793. [4] Islam AF, Rahman MS.Levofloxacin-induced fatal toxic epidermal necrolysis[J]. Ann Pharmacother, 2005, 39(6):1136-1137. [5] Christie MJ, Wong K, Ting RH, et al.Generalized seizure and toxic epidermal necrolysis following levofloxacin exposure[J]. Ann Pharmacother, 2005, 39(5):953-955. [6] Davila G, Ruiz-Hornillos J, Rojas P, et al.Toxic epidermal necrolysis induced by levofloxacin[J]. Ann Allergy Asthma Immunol, 2009,102(5):441-442. [7] Teo WL, Pang SM.Levofloxacin-induced toxic epidermal necrolysis treated with intravenous immunoglobulin[J]. Ann Acad Med Singapore,2010, 39(8):660-661. [8] Varma SK, Sutradhar S, Misra AK.Levofloxacin and furazolidone induced toxic epidermal necrosis[J]. Indian J Pharmacol, 2013,45(6):625-626. [9] 徐利君, 李星霞. 左氧氟沙星疑致中毒性表皮坏死松解型药疹1例[J]. 中国药物应用与监测. 2015, 12(4):258-260. [10] Uzun R, Yalcin AD, Celik B, et al.Levofloxacin Induced Toxic Epidermal Necrolysis: Successful Therapy with Omalizumab (Anti-IgE) and Pulse Prednisolone[J]. Am J Case Rep, 2016(17):666-671. [11] Gajjar K, Hirapara H, Jaiswal CS, et al.A Case Report of Antitu-bercular Drugs Induced Exanthematous Reaction Complicated by Acute Onset Levofloxacin Induced Toxic Epidermal Necrolysis (TEN)[J]. Curr Drug Saf, 2018, 13(1):41-43. [12] 杨梦婕. 抗菌药物引发中毒性表皮坏死松懈症致死亡1例[J].湖北科技学院学报(医学版), 2017, 31(5):87-89. [13] 程云忠, 龚春龙, 鲍同柱, 等. 血栓通与哌拉西林致中毒性表皮坏死松解症一例并文献复习[J]. 实用药物与临床, 2014,17(10):1329-1331. [14] Shah MM, Larson K, Kundu N, et al.Postoperative Stevens-Johnson syndrome secondary to piperacillin-tazobactam: A case report[J]. International Journal of Case Reports and Images, 2013,4(6):316-320. [15] 王凌. 哌拉西林钠他唑巴坦钠致中毒性表皮坏死松解症[J]. 药物不良反应, 2016, 18(6): 451-452. [16] 刘立立, 黄玲, 胡正波, 等. 哌拉西林钠他唑巴坦钠致大疱表皮松解型药疹1例[J]. 中国药物警戒, 2013, 10(11):69-70. [17] 杜巨豹, 褚燕琦, 郭爽, 等. 亚胺培南西司他丁钠相关中毒性表皮坏死松懈症[J]. 药物不良反应杂志, 2010, 12(6):431-433. [18] 徐锦龙, 王雄雄, 陈武, 等. 亚胺培南西司他丁钠致中毒性表皮坏死松解型药疹1例[J]. 中国药物应用与监测, 2014,11(5):325-326. [19] 佘秋云, 董盈盈, 邓云华.《2016英国成人Stevens-Johnson综合征/中毒性表皮坏死松解症管理指南》解读[J]. 中国医学文摘-皮肤科学, 2017, 34(3):273-278. [20] Nassif A, Bensussan A, Boumsell L, et al.Toxic epidermal necrolysis: effector cells are drug-specific cytotoxic T cells[J]. JAllergy Clin Immunol, 2004, 114(5):1209-1215. [21] Downey A, Jackson C, Harun N, et al.Toxic epidermal necrolysis:review of pathogenesis and management[J]. J Am Acad Dermatol, 2012, 66(6):995-1003. [22] 程新民, 李莉, 田月洁. HLA-B~*1502等位基因与抗癫痫药物致不同种族严重皮肤不良反应的研究进展[J]. 中国药物警戒, 2011, 8(4):237-239. [23] 裴媛, 王瑞, 王单单, 等. HLA-B~*5801基因多态性与别嘌醇致皮肤不良反应的文献分析[J].中国药物警戒, 2019, 16(3):154-156, 163. [24] Hung SI, Chung WH, Liou LB, et al.HLAB*5801 allele as a genetic marker for severe cutaneous adverse reactions caused byallopurinol[J]. Proc Nat Acad Sci USA, 2005, 102(11):4134-4139. [25] 陈勇彬. 大疱性表皮坏死松解型药疹致疹药物文献分析[J].中国临床新医学, 2012, 5(1): 27-29. [26] Hirahara K, Kano Y, Sato Y, et al.Methylprednisolone pulse therapy for Stevens-Johnson syndrome/toxic epidermal necrolysis:Clinical evaluation and analysis of biomarkers[J]. J Am Acad Dermatol,2013, 69(3):496-498. [27] Schneck J, Fagot JP, Sekul P, et al.Effects of treatments on the mortality of Stevens-Johnson syndrome and toxic epidermal necrolysis:A retrospective study on patients included in the prospective EuroSCAR Study[J]. J Am Acad Dermatol,2008, 58(1):33-40. [28] Gupta LK, Martin AM, Agarwal N, et al.Guidelines for the mana-gement of Stevens-Johnson syndrome/toxic epidermal necrolysis:An Indian perspective[J]. Indian J Dermatol Venereol Leprol,2016, 82(6):603-625. [29] Zimmermann S, Sekula P, Venhoff M, et al.Systemic Immuno-modulating Therapies for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Systematic Review and Meta-analysis[J].JAMA Dermatol, 2017, 153(6):514-522. [30] Yang Y, Xu J, Li F, et al.Combination therapy of intravenous immunoglobul in and corticosteroid in the treatment of toxic epidermal necrolysis and Stevens-Johnson syndrome: a retrospe-ctive comparative study in China[J]. Int J Dermatol, 2009, 48(10):1122-1128. [31] 饶燕, 陶春蓉. 糖皮质激素联合免疫球蛋白治疗中毒性表皮坏死松解症25例临床观察[J]. 中国皮肤性病学杂志, 2017,31(2):165-167.