Epidermolytic drug reactions to antibiotics: onset and mucosal impact.

| Posted in: Science

Journal name: World Journal of Pharmaceutical Research
Original article title: Epidermolytic adverse cutaneous drug reactions due to systemic antibiotics – onset and mucous membranes' affection
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Original source:

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Author:

Ietimad Abdelsalam Mohamed Ayed and Mohammed Helmy Faris Shalayel


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: Epidermolytic adverse cutaneous drug reactions due to systemic antibiotics – onset and mucous membranes' affection

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

Doi: 10.20959/wjpr201611-7244

Copyright (license): WJPR: All rights reserved


Download the PDF file of the original publication


Summary of article contents:

Introduction

Epidermolytic adverse cutaneous drug reactions (CADRs), particularly those triggered by systemic antibiotics, present significant medical challenges. These reactions range from mild maculopapular rashes to severe conditions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Both SJS and TEN adversely affect the skin and mucous membranes, leading to severe discomfort and potential mortality. This study aimed to investigate the prevalence of epidermolytic adverse cutaneous drug reactions among Sudanese patients, focusing on the characteristics of the onset and involvement of mucous membranes.

Onset of Adverse Reactions

One critical finding of this study is the onset timing of epidermolytic adverse cutaneous drug reactions. A significant portion of the patients (53.7%) exhibited initial symptoms within one week of antibiotic administration. This rapid onset highlights the urgent need for clinicians to recognize and address potential drug-related cutaneous reactions promptly. In contrast, 41.5% of cases had their onset between one to two weeks post-drug administration, with only 4.9% showing symptoms after a duration exceeding two weeks. This information underscores the importance of obtaining precise medication histories to identify the offending drugs swiftly, as early intervention may prevent serious complications.

Mucous Membrane Involvement

The study reveals that mucous membrane affection occurred in all patients examined, with ocular and oral mucosal sites being the most affected. Specifically, 34.1% of patients experienced only oral involvement, while 41.5% exhibited ocular affection—highlighting the prominence of these areas in adverse reactions. Furthermore, combinations of affected sites were documented, such as 22% with oral and genitalia involvement and 14.6% with both oral and eye impact. The patterns of involvement can contribute to patient discomfort and complications, emphasizing the need for increased awareness among healthcare providers regarding the systemic effects of cutaneous drug reactions.

Types of Drug Reactions

Epidermolytic adverse cutaneous reactions accounted for 58.6% of all antibiotic-related skin responses in this study. Various antibiotics were identified as potential culprits, with ciprofloxacin being the most frequently implicated. Other antibiotics like artesunate, penicillins, and sulfamethoxazole-trimethoprim also contributed to the incidence of SJS and TEN. The spectrum of clinical manifestations related to these drug reactions ranges from maculopapular rashes to more serious conditions like EM-major, SJS, and TEN. Understanding the spectrum of drug reactions is crucial for effective diagnosis and treatment, as timely recognition can dramatically alter patient outcomes.

Conclusion

In conclusion, this study underscores that epidermolytic adverse cutaneous drug eruptions are prevalent among patients receiving systemic antibiotics, particularly in the Sudanese population studied. The findings point to a critical association between rapid onset post-drug administration and severe mucous membrane affection. With ocular and oral involvement being the predominant sites, healthcare practitioners must remain vigilant in monitoring adverse reactions to prevent severe consequences. Future research with larger sample sizes is warranted to further explore the complexities of interactions between host factors and antibiotics, aiding in improved patient management and outcomes.

FAQ section (important questions/answers):

What are epidermolytic adverse cutaneous drug reactions to antibiotics?

Epidermolytic adverse cutaneous drug reactions are severe skin reactions caused by antibiotics, ranging from mild rashes to life-threatening conditions like Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). These reactions often involve mucous membranes.

What were the main findings of the study on drug reactions?

The study found that 58.6% of cutaneous adverse drug reactions were epidermolytic in nature, with mucous membranes being affected in 100% of patients. Common sites included the oral cavity and eyes.

What was the common antibiotic linked to skin reactions in this study?

Ciprofloxacin was the most implicated antibiotic, accounting for 41.46% of cases. Other antibiotics, like artesunate and various penicillins, also contributed to the overall reactions.

What was the timeframe for the onset of reactions after drug administration?

The study showed that 53.7% of patients experienced reactions within less than one week after starting the offending drug, while 41.5% had onset within one to two weeks.

How did mucous membrane affection manifest among the patients?

Mucous membrane affection occurred in all patients, with oral and ocular sites being the most affected. Oral involvement was noted in 34.1% of cases, while ocular affection was seen in 41.5%.

What recommendations were made for future studies?

The study recommended conducting further research with larger sample sizes. This would help better understand the complex interactions between the host, drugs, and other factors, including infections and environmental influences.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Epidermolytic drug reactions to antibiotics: onset and mucosal impact.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Drug:
The term 'drug' refers to any chemical substance that, when administered to a living organism, affects physiological functions. In the context of the study, drugs are the primary agents that cause adverse reactions, particularly antibiotics, which can lead to various cutaneous side effects such as SJS and TEN. Understanding the role of drugs is crucial for clinicians diagnosing and managing drug-related adverse reactions.

2) Antibiotic (Antibacterial):
Antibiotics are a specific class of drugs designed to combat bacterial infections. They play a significant role in modern medicine; however, they can cause severe adverse cutaneous reactions such as toxic epidermal necrolysis and Stevens Johnson syndrome. Knowledge of which antibiotics are implicated in adverse reactions assists healthcare providers in patient management.

3) Affection:
In medical terminology, 'affection' describes the involvement or impact of a disease or condition on the body. In this study, affection refers to the involvement of mucous membranes in drug reactions, highlighting the systemic effects of certain antibiotics which led to significant observations in the patients' oral and ocular areas.

4) Study (Studying):
The term 'study' refers to conducting organized research to gather information and insights on a specific topic. In this document's context, the study investigates the prevalence of epidermolytic adverse cutaneous drug reactions due to systemic antibiotics, aiming to provide empirical data that can ameliorate clinical practices and patient management.

5) Disease:
A 'disease' is a pathological condition of a bodily part, an organism, or system resulting from various factors, including infection, genetic defects, and environmental influences. This study addresses diseases associated with adverse cutaneous reactions to drugs, especially antibiotics—which can result in life-threatening conditions like TEN and SJS.

6) Table:
In the context of the study, 'table' refers to a structured presentation of data that summarizes findings systematically. Tables are utilized to provide clear, concise comparisons and patterns of drug reactions and affected mucous membranes, making the data accessible for analysis and reference in clinical decision-making.

7) Detachment:
Detachment describes the process of separation, particularly in the context of skin layers in severe drug reactions. In the study, epidermal detachment is a critical issue associated with toxic epidermal necrolysis, where skin layers separate and result in significant morbidity, necessitating urgent medical attention.

8) Teaching:
The term 'teaching' in this context implies the educational aspect related to clinical training within the dermatology department. Understanding adverse drug reactions and their signs, such as SJS and TEN, is crucial for medical students and professionals to ensure prompt recognition and intervention.

9) Cutan:
Sudan is the location where this study took place, providing cultural and demographic context to the findings. The prevalence and presentation of drug reactions may differ between populations, making it essential to examine such reactions within the specific healthcare framework and practices relevant to Sudanese patients.

10) Developing:
The term 'developing' refers to countries or regions with lower socioeconomic status and healthcare resources. The study emphasizes the difference in drug reaction incidence rates between developed and developing nations, highlighting the need for targeted research and healthcare strategies in less-resourced settings such as Sudan.

11) Science (Scientific):
Science is the systematic study of the structure and behavior of the physical and natural world through observation and experimentation. This study forms part of medical science, focusing on elucidating the mechanisms behind adverse drug reactions, an essential aspect of improving healthcare outcomes.

12) Burning sensation:
The 'burning sensation' is a common clinical symptom reported by patients with mucosal involvement due to drug reactions. It indicates potential injury or irritation of mucous membranes, such as those in the mouth or eyes, and is a significant finding in understanding the overall impact of cutaneous drug reactions.

13) Pharmacological:
Pharmacological pertains to the branch of medicine concerned with the study of drugs and their effects. This study's pharmacological insight is essential for understanding how specific antibiotics can cause cutaneous adverse reactions and the need to evaluate drug interactions and mechanisms in affected patients.

14) Pharmacology:
Pharmacology is the science of drugs, encompassing their effects, mechanisms of action, and therapeutic applications. The study of pharmacology is vital for understanding adverse drug reactions to antibiotics, informing both research and clinical practices in managing patient care and ensuring drug safety.

15) Discussion:
The term 'discussion' refers to the section of a study where researchers interpret and contextualize their findings. It provides insights into the implications of the results concerning existing literature, aiding in the understanding of the clinical relevance of drug reactions and reinforcing the need for preventative strategies.

16) Practising (Practicing):
Practicing refers to the ongoing application of knowledge and skills in a professional context. For physicians, particularly those in dermatology, understanding the prevalence and manifestations of drug reactions is crucial for providing quality patient care and making informed decisions in treatment and drug prescription.

17) Swallowing:
Swallowing is the act of moving food or liquid from the mouth to the stomach. In the context of the study, difficulties with swallowing may arise from mucous membrane affections due to drug reactions, emphasizing the importance of recognizing and managing such toxic side effects.

18) Education:
Education is the process of imparting knowledge and skills to individuals. In the medical field, education extends to understanding drug reactions and their clinical implications, ensuring healthcare professionals are well-equipped to identify and manage adverse drug events in patients.

19) Resolving:
Resolving refers to the process of effectively managing and eliminating symptoms or conditions. In the context of the study, resolving drug reactions is a critical goal in patient care, as effective identification and treatment can prevent complications that may lead to increased morbidity or mortality.

20) Medicine:
Medicine is the science of diagnosing, treating, and preventing disease. The relevance of medicine in this study lies in its focus on acknowledging and understanding the adverse effects of antibiotics on skin and mucous membranes, thereby improving pharmaceutical practices and patient outcomes.

21) Account:
Account refers to the detailed reporting or explanation of findings. In a medical context, providing a comprehensive account of drug reactions is essential for awareness, educating healthcare professionals, and improving clinical practices to enhance patient safety in drug prescribing.

22) Burning (Burn, Burned, Burnt):
Burning, a term frequently used to describe a painful sensation in affected areas, is a notable symptom for individuals experiencing cutaneous drug reactions. This symptom often indicates underlying tissue irritation and inflammation, and recognizing it is crucial for timely intervention and treatment.

23) Allergy:
Allergy denotes a hypersensitive reaction of the immune system to substances, which can include drug components. The study on epidermolytic reactions brings forth discussions regarding allergic reactions to antibiotics, which can cause severe and occasionally fatal cutaneous and systemic responses requiring immediate medical attention.

24) Animal:
Animal studies often contribute to initial research on drug efficacy and safety. While the study focuses on human reactions to antibiotics, understanding the principles derived from animal studies can be fundamental in predicting human responses, ensuring ethical and scientifically robust practices in pharmacology.

25) Edema (Oedema):
Edema is the medical term for swelling caused by excess fluid trapped in bodily tissues. In the context of drug reactions, edema may present alongside other symptoms in cases of severe skin reactions or mucosal involvement, highlighting the complexity and potential severity of cutaneous adverse drug events.

26) Fever:
Fever is a common systemic symptom, indicating an inflammatory response, which may occur in association with drug reactions. It is often one of the initial signs manifesting in conditions like SJS and TEN, thus serving as a critical marker for clinicians in the early detection of serious adverse effects.

27) Death:
Death in this context refers to the potential fatal outcomes of severe drug reactions like TEN and SJS. Awareness of this risk underscores the importance of prompt identification and management of drug-related adverse reactions to minimize severe complications and enhance patient safety.

28) Visit:
Visit typically refers to a patient's attendance at a healthcare facility for evaluation and treatment. The context of the study highlights the significance of patient visits following adverse drug reactions, underscoring the need for timely intervention and management of symptoms to ensure optimal healthcare outcomes.

29) Blood:
Blood is the fluid that circulates in the body's arteries and veins, carrying essential cells and substances. In this study, understanding blood-related factors, such as previous transfusions or underlying conditions, is crucial for evaluating patient responses to drugs and the potential for adverse reactions.

30) Ras (Rash):
A rash is a noticeable change in the skin that can manifest as redness, bumps, or lesions due to various factors, including drug reactions. It serves as a primary indication of adverse cutaneous drug reactions, and recognizing this can help with early diagnosis and effective treatment.

31) Pain:
Pain is an unpleasant sensory experience often associated with tissue damage or irritation. In relation to drug reactions, recognizing reported pain allows healthcare professionals to assess the severity of mucosal or cutaneous involvement and make informed decisions regarding treatment and management strategies.

32) Life:
Life relates to the existence of individuals and their overall health. In the context of adverse drug reactions, understanding the impact of medications on quality of life is vital; severe drug eruptions can significantly affect daily functioning and necessitate careful monitoring and intervention.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Epidermolytic drug reactions to antibiotics: onset and mucosal impact.’. Further sources in the context of Science might help you critically compare this page with similair documents:

Mucosal membrane, Adverse drug reactions (ADR), Dermatological examination, Hospital based study, Prospective descriptive study, Human ethical committee, Systemic antibiotic.

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