A retrospective analysis of infections and antibiotic treatment in patients with Stevens-Johnson syndrome and toxic epidermal necrolysis

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare drug-related life-threatening acute conditions. Infection is a major cause of morbidity and mortality in these patients. The aim of this study was to analyze the infective characteristics and antimicrobial strategies in patients with SJS and TEN. Methods: A total of 125 patients who were diagnosed with SJS/TEN in West China Hospital from 2010 to 2017 were retrospectively analyzed. Results: There were 75 patients with coinfections (75/125, 60%), of whom 44 had SJS (44/90, 48.9%) and 31 had TEN (31/35, 88.6%). The most common infections were skin infections and pulmonary infections. Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) were the most frequently identified pathogenic organisms. The most common antibiotics used in patients with infections were vancomycin, carbapenems, quinolones, macrolides, and lincomycin. Conclusions: Antimicrobial therapy should be administered promptly if there are clinical signs of an infection. Empiric antibiotic selection is based on knowledge of the local microbiota, the different infected sites, the pathogens involved, and the severity of disease.