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Microbiological findings and antibacterial therapy in Stevens-Johnson syndrome/toxic epidermal necrolysis patients from a Swedish Burn Center
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.ORCID iD: 0000-0002-9735-1434
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
2017 (English)In: Journal of cutaneous pathology, ISSN 0303-6987, E-ISSN 1600-0560, Vol. 44, no 5, 420-432 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Superimposed infections/sepsis are the major cause of morbidity/mortality in Stevens-Johnson syndrome/Toxic Epidermal Necrolysis (SJS/TEN). It is a delicate balance between avoiding new pharmaceuticals and prophylactically treat an incipient infection. The objective of this study was to investigate the rates and types of infection-microbials and antibiotics involved in SJS/TEN patients.

MATERIALS AND METHODS: Microbiology and clinical data were collected for SJS/TEN patients admitted to our Burn Center from January 2010 through January 2016.

RESULTS: A total of 24 patients were admitted over the study period. There were 303 bacterial cultures taken whereof 113 (37.3%) were positive (median of 4.4 per patient). Twenty-two (91.7%) patients had at least 1 positive sample recorded. Fifteen (62.5%) patients had a confirmed episode of sepsis with skin being the most common source of colonization (77.8%). Eleven (45.8%) patients received empiric antibiotic therapy at referral facility/prior to admission to our Center. Patients who grew a higher number of different species were significantly less likely to have received early empiric antimicrobial therapy (Pā€‰<ā€‰.001).

CONCLUSION: Secondary bacterial infection and sepsis were a highly common finding in our patient population. Despite the risk of resistance and further immunological provocation, empirical antibiotic treatment might have a place in clinical management.

Place, publisher, year, edition, pages
2017. Vol. 44, no 5, 420-432 p.
Keyword [en]
Stevens-Johnson syndrome, antibiotic therapy, bacterial infection, management, toxic epidermal necrolysis
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:uu:diva-316979DOI: 10.1111/cup.12894ISI: 000399009500002PubMedID: 28075032OAI: oai:DiVA.org:uu-316979DiVA: diva2:1079432
Available from: 2017-03-08 Created: 2017-03-08 Last updated: 2017-05-23Bibliographically approved

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