Full
Outline
To investigate the clinical characteristics of severe drug eruption induced by antibacterial drugs and provide aid for their safe use in clinical practice.
Case reports of severe cutaneous adverse reactions induced by antibacterial drugs were retrieved from Medline, CNKI and Wanfang databases from inception to December 31, 2020. The clinical features of these ADRs were summarized and analyzed. The risk factors were analyzed by binary Logic regression.
A total of 241 cases were collected, including 131 males (54.4%) and 110 females (45.6%). Severe cutaneous adverse reactions (SCARs) occurred in all age groups. The median onset time of antibacterial drugs-induced SCARs was 2 d and the median duration was 15 d. The main allergenic drugs were penicillin (55/21.7%), fluoroquinolones (46/18.2%), cephalosporins (39/15.4%), and glycopeptides (25/9.9%). Patients with toxic epidermal necrolysis (TEN) had a higher risk of death than Steven Johnson syndrome (SJS) [odd ratio (OR)=0.263, P=0.006] and exfoliative dermatitis (ED) (OR=0.52, P=0.016) (P<0.05); patients treated with glucocorticoid (OR=0.117, P=0.027) or immunoglobulin (OR=0.042, P=0.001) had a lower risk of death than treated with symptomatic supportive care. There was no statistical difference between glucocorticoid combined with immunoglobulin therapy and symptomatic supportive therapy (OR=0.899, P=0.950).
The mortality of severe drug eruption caused by antimicrobial drugs is high, so it is necessary to strengthen the monitoring of early signs in clinical practice, and immediately stop using suspicious drugs, and choose alternative antimicrobial drugs with different structures to avoid the recurrence of severe cutaneous adverse reactions.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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