Antibiotik Terkait Sindrom Stevens Johnson dan Toxic Epidermal Necrolysis

Oleh :

dr.Megawati Tanu

Antibiotik merupakan salah satu jenis obat yang paling banyak dikaitkan dengan sindrom Stevens-Johnson (SSJ) dan toxic epidermal necrolysis (TEN). Dalam sebuah studi, dilaporkan bahwa golongan antibiotik yang paling banyak mencetuskan SSJ dan TEN di seluruh dunia adalah golongan sulfonamida (32%), penicillin (22%), sefalosporin (11%), fluoroquinolone (4%), dan makrolida (2%).[1]

SSJ dan TEN merupakan reaksi berat mukokutan akut yang bermanifestasi sebagai erosi mukosa, hilangnya lapisan epidermis, nekrosis kulit, serta gejala sistemik. Kondisi ini cukup langka dan berpotensi fatal bagi penderitanya. Berdasarkan luas permukaan kulit yang terkena, pasien diklasifikasikan menjadi SSJ bila <10% luas permukaan tubuh; diklasifikasikan SSJ-TEN bila melibatkan 10-30% luas permukaan tubuh; dan TEN bila >30% luas permukaan tubuh.[1-3]

Sumber: Wikimedia Commons, 2018.

Kaitan Antibiotik dengan Sindrom Stevens Johnson dan Toxic Epidermal Necrolysis

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Referensi

1. Lee EY, Knox C, Phillips EJ. Worldwide Prevalence of Antibiotic-Associated Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Systematic Review and Meta-analysis. JAMA Dermatol. 2023 Apr 1;159(4):384–92.
2. Fukasawa T, Urushihara H, Takahashi H, Okura T, Kawakami K. Risk of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Associated With Antibiotic Use: A Case-Crossover Study. J Allergy Clin Immunol Pract. 2023 Nov;11(11):3463-3472. doi: 10.1016/j.jaip.2023.07.012.
3. Oakley AM, Krishnamurthy K. Stevens-Johnson Syndrome. In: StatPearls. StatPearls Publishing; 2023.
4. Lipovy B, Holoubek J, Hanslianova M, et al. Impact of Antibiotics Associated with the Development of Toxic Epidermal Necrolysis on Early and Late-Onset Infectious Complications. Microorganisms. 2021 Jan 19;9(1):202. doi: 10.3390/microorganisms9010202.
5. Abulatan IT, Ben-David SG, Morales-Colon LA, Beason E, Fakoya AO. A Compilation of Drug Etiologies of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. Cureus. 2023 Nov 13;15(11):e48728. doi: 10.7759/cureus.48728.
6. Fakoya AOJ, Omenyi P, Anthony P, Anthony F, Etti P, Otohinoyi DA, Olunu E. Stevens - Johnson Syndrome and Toxic Epidermal Necrolysis; Extensive Review of Reports of Drug-Induced Etiologies, and Possible Therapeutic Modalities. Open Access Maced J Med Sci. 2018 Mar 28;6(4):730-738. doi: 10.3889/oamjms.2018.148.
7. Lin YF, et al. Severe Cutaneous Adverse Reactions Related to Systemic Antibiotics. Clinical Infectious Diseases, 2014. 58(10), 1377–1385. doi:10.1093/cid/ciu126
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9. Boroda K, Li L, Riina L, Ahmed S. Cephalosporin-Induced Toxic Epidermal Necrolysis Treated with Intravenous Immunoglobulin. Cureus. 2015 Oct 21;7(10):e359. doi: 10.7759/cureus.359.
10. Pejčić AV. Stevens-Johnson syndrome and toxic epidermal necrolysis associated with the use of macrolide antibiotics: a review of published cases. Int J Dermatol. 2021 Jan;60(1):12-24. doi: 10.1111/ijd.15144.
11. Ubukata N, Nakatani E, Hashizume H, Sasaki H, Miyachi Y. Risk factors and drugs that trigger the onset of Stevens-Johnson syndrome and toxic epidermal necrolysis: A population-based cohort study using the Shizuoka Kokuho database. JAAD Int. 2022 Dec 24;11:24-32. doi: 10.1016/j.jdin.2022.12.002.
12. Gronich N, Maman D, Stein N, Saliba W. Culprit Medications and Risk Factors Associated with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Population-Based Nested Case-Control Study. Am J Clin Dermatol. 2022 Mar;23(2):257-266. doi: 10.1007/s40257-021-00661-0.