Oritavancin-Induced Toxic Epidermal Necrolysis (TEN): A Case Report

Abstract

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe immune responses to an external stimulus which can lead to significant rates of mortality. Oritavancin is a lipoglycopeptide approved for the treatment of acute bacterial skin and skin structure infections. Oritavancin possesses an extremely long half-life that allows the advantage of a single one-to-three-hour infusion. While prior reports showed few occurrences of SJS/TEN in patients treated with other lipoglycopeptide antibiotics such as dalbavancin, there are no reports for oritavancin. The purpose of this case report is to notify the medical community of an SJS/TEN reaction to oritavancin, of which none have been documented prior to this report. This patient was admitted and treated in the burn intensive care unit of Doctors Hospital of Augusta in October 2023. TEN was diagnosed and treated following a standard protocol and the acute phase of TEN including sloughing of the skin did subside soon after admission. This case report documents the first occurrence of SJS/TEN in an oritavancin patient and allows this condition to be included as a possible adverse drug reaction to this agent.