Amoxicillin-associated Stevens-Johnson syndrome or toxic epidermal necrolysis: systematic review

Pejčić, Ana V; Milosavljević, Miloš N.; Folić, Marko; Fernandes, Diana; Bentes, João; Djesevic, Miralem; Janković, Slobodan

doi:10.1080/1120009x.2022.2051128

Cited by 4 publications

(2 citation statements)

References 74 publications

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“…Um et al found that the latency period in antibiotic-induced DRESS was significantly shorter than in anticonvulsant-induced DRESS( Um et al, 2010 ). Drug-related skin changes generally begin to appear after 1–3 weeks of continuous drug use, and the latent period for cutaneous adverse drug reactions with SJS/TEN phenotype in this study was 8.5 days on average, which was consistent with recent reports ( Lee et al, 2023 ; Pejcic et al, 2023 ).…”

Section: Discussionsupporting

confidence: 92%

“…Amoxicillin (AMX) is among the most prescribed and the best tolerated antimicrobials worldwide ( Sharland et al, 2018 ). However, AMX is also one of the most common drug allergy labels in the electronic health record, it can occasionally trigger severe cutaneous adverse reactions (SCAR), such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reactions with eosinophilia and systemic symptoms (DRESS), and drug-induced acute erythroderma, with a significant morbidity and mortality ( Aouam et al, 2010 ; Girelli et al, 2013 ; Pejcic et al, 2023 ). In time of the development of SCAR in combination medicines and antibiotic resistant settings, future exposure to all concurrently dosed drugs is contraindicated, seriously restricting the choice of candidate drugs for the patients ( Sodhi et al, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

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The association between HLA-B variants and amoxicillin-induced severe cutaneous adverse reactions in Chinese han population

Wang,

Yang,

Yang

et al. 2024

Front. Pharmacol.

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BackgroundAmoxicillin (AMX) is among the most prescribed and the best tolerated antimicrobials worldwide. However, it can occasionally trigger severe cutaneous adverse reactions (SCAR) with a significant morbidity and mortality. The genetic factors that may be relevant to AMX-induced SCAR (AMX-SCAR) remain unclear. Identification of the genetic risk factor may prevent patients from the risk of AMX exposure and resume therapy with other falsely implicated drugs.MethodologyFour patients with AMX-SCAR, 1,000 population control and 100 AMX-tolerant individuals were enrolled in this study. Both exome-wide and HLA-based association studies were conducted. Molecular docking analysis was employed to simulate the interactions between AMX and risk HLA proteins.ResultsCompared with AMX-tolerant controls, a significant association of HLA-B*15:01 with AMX-SCAR was validated [odds ratio (OR) = 22.9, 95% confidence interval (CI): 1.68–1275.67; p = 7.34 × 10−3]. Moreover, 75% carriers of HLA-B*15:01 in four patients with AMX-SCAR, and the carrier frequency of 10.7% in 1,000 control individuals and 11.0% in 100 AMX-tolerant controls, respectively. Within HLA-B protein, the S140 present in all cases and demonstrated the strongest association with AMX-SCAR [OR = 53.5, p = 5.18 × 10−4]. Molecular docking results also confirmed the interaction between AMX and S140 of the HLA-B protein, thus eliminating the false-positive results during in association analysis.ConclusionOur findings suggest that genetic susceptibility may be involved in the development of AMX-SCAR in Han Chinese. However, whether the HLA-B variants observed in this study can be used as an effective genetic marker of AMX-induced SCAR still needs to be further explored in larger cohort studies and other ethnic populations.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

The association between HLA-B variants and amoxicillin-induced severe cutaneous adverse reactions in Chinese han population

Wang,

Yang,

Yang

et al. 2024

Front. Pharmacol.

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A nationwide study of Stevens–Johnson syndrome and toxic epidermal necrolysis in hospitalized pregnant women in the United States, 2009–2020

Wasuwanich,

Egerman,

Wen

et al. 2024

JAAD International

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A Case Report of Cefixime, Paracetamol, and Nimesulide Induced Toxic Epidermal Necrolysis in a Woman with Dengue Infection without any Other Associated Comorbidities

Munshi

Maurya

2024

CDS

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Background: Toxic Epidermal Necrolysis (TEN) is a rare, acute, and life-threatening mucocutaneous disease that occurs after the administration of certain drugs, resulting in extensive keratinocyte cell death, skin involvement at the dermal-epidermal junction, and extensive bullous skin eruptions and sloughing. Many published case reports have observed the presence of fever with a viral infection, drug, and/or genetic association as a possible trigger for TEN but associated with other comorbidities. Physicians still struggle to predict which individuals could be predisposed to TEN. The case report that we present had a history of multiple drug intake and fever due to dengue virus infection but was not associated with any Case Presentation: We present an unusual case of a 32-year-old woman of Western Indian origin who had developed dengue infection and suffered toxic epidermal necrolysis following a five-day course of a third-generation cephalosporin antibiotic, cefixime and a three-day course of 2 analgesic drugs, paracetamol (acetaminophen), and nimesulide, with the adverse event occurring on the fifth day of the dengue infection. The offending drugs were stopped, and patient survived with supportive management and hydration. Conclusion: The presence of comorbidities may not always be the triggering factor for TEN, though it can affect patient outcomes. Rational drug use is always recommended for patient care. Further research is required to understand the pathomechanism behind the viral-drug-gene interaction.

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Amoxicillin-associated Stevens-Johnson syndrome or toxic epidermal necrolysis: systematic review

Cited by 4 publications

References 74 publications

The association between HLA-B variants and amoxicillin-induced severe cutaneous adverse reactions in Chinese han population

The association between HLA-B variants and amoxicillin-induced severe cutaneous adverse reactions in Chinese han population

A nationwide study of Stevens–Johnson syndrome and toxic epidermal necrolysis in hospitalized pregnant women in the United States, 2009–2020

A Case Report of Cefixime, Paracetamol, and Nimesulide Induced Toxic Epidermal Necrolysis in a Woman with Dengue Infection without any Other Associated Comorbidities

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