Abstract

CEFIXIME INDUCED STEVENS JOHNSON SYNDROME – A CASE REPORT

Dr. R. Lavanya MBBS, MD (Pharm)*

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Abstract

Stevens-Johnson Syndrome is an acute, rare and potentially fatal immune-mediated hypersensitivity reaction affecting the mucous membrane and the skin. It is the severe form of cutaneous drug reaction with underlying genetic etiology. Here, we report a 14 year old female presenting with multiple hyperpigmented patches, erythematous bullae of varying sizes all over the trunk and the limbs following intake of two tablets of Cefixime hydrochloride 200mg. The skin lesions appeared one day after the ingestion of the tablet for Lower Respiratory Tract Infection with fever. She was given supportive treatment and the skin lesions were taken care of. She was advised to stop Cefixime tablet. WHO Causality assessment scale and Naranjo’s algorithm revealed that the adverse drug reaction was classified as ‘probable’. Cefixime, rarely causes such skin lesions and there is a possible link with individual’s human leucocyte antigen allele and cutaneous reactions. Hence, there is a need for more exploration in the field of pharmacogenomics of HLA- associated drug reactions and its application for individualized drug therapy and reducing unwanted drug induced reactions.

Keywords: Stevens-Johnson Syndrome, Cefixime hydrochloride, Probable, Pharmacogenomics, Human Leukocyte Antigen, genetic susceptibility.