Nevirapine and the risk of Stevens–Johnson syndrome or toxic epidermal necrolysis
@article{Fagot2001NevirapineAT, title={Nevirapine and the risk of Stevens–Johnson syndrome or toxic epidermal necrolysis}, author={J. P. Fagot and M. Mockenhaupt and Jan-Nico Bouwes-Bavinck and Luigi Naldi and Cecile G. Viboud and Jean Claude Roujeau}, journal={AIDS}, year={2001}, volume={15}, pages={1843-1848} }
ObjectiveTo draw attention to the many cases of Stevens–Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) related to nevirapine detected in a multinational case–control study of SJS and TEN. MethodsActively detected cases and matched hospital controls were interviewed for exposure to drugs and other risk factors. Data were analysed with case–control and case-crossover methods. ResultsBetween May 1997 and November 1999, a diagnosis of SJS or TEN was established in 246 patients. Eighteen…
434 Citations
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Clinicians should be aware that amoxicillin alone or combined with clavulanic acid can cause SJS/TEN in patients of all ages.
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Management of patients with SJS/TEN requires rapid diagnosis, evaluation of the prognosis using SCORTEN, rapid identification and interruption of the culprit drug, specialized supportive care ideally in an intensive care unit, and the consideration of immunomodulatory agents such as high-dose intravenous immunoglobulin.
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High-dose corticosteroids were effective in SJS, whereas intra-venous immunoglobulin were useful in TEN and SJS/TEN overlap syndrome, and anti-convulsants were the most frequently implicated drugs.
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A multinational case-control study conducted in Europe between 1997 and 2001 evaluated the risk of medications to induce SCAR, finding that many cases were still related to a few "old" drugs with a known high risk, and risk was restricted to the first few weeks of drug intake.
Toxic epidermal necrolysis and Stevens-Johnson syndrome in South Africa: a 3-year prospective study.
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The use of the TEN-specific severity-of-illness score (SCORTEN) was validated and several prognostic indicators were identified, most significant being HIV-tuberculosis co-infection, ≥40% skin involvement and severe sepsis.
Fatal toxic epidermal necrolysis induced by carbamazepine treatment in a patient who previously had carbamazepine-induced Stevens-Johnson syndrome.
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