Pristinamycin-induced toxic epidermal necrolysis: A case report

Br J Clin Pharmacol. 2024 Aug;90(8):1869-1872. doi: 10.1111/bcp.15600. Epub 2022 Nov 30.

Abstract

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute, life-threatening and rare severe cutaneous adverse reactions induced by drugs in most cases. The drugs most often reported to be implicated in inducing TEN/SJS are allopurinol, antibacterial sulfonamides, antiepileptic drugs and oxicam. Pristinamycin is an oral streptogramin antibiotic with bactericidal activity against Gram-positive bacteria that is rarely linked to TEN. Typically, this condition develops 4-28 days after drug exposure, Herein, we report a case of a 71-year-old female who developed TEN within 3 days of administration of pristinamycin and was managed successfully with supportive care, including intravenous fluids, pain control, prophylactic antibiotics and intravenous methylprednisolone. This case of rapidly developing SJS/TEN after administration of pristinamycin highlights the possibility that these complications can develop within only a few days following ingestion of drugs thought to be probably safe.

Keywords: pristinamycin; severe cutaneous adverse reaction; toxic epidermal necrolysis‐Steven—Johnson syndrome.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents* / adverse effects
  • Anti-Bacterial Agents* / therapeutic use
  • Female
  • Humans
  • Methylprednisolone / administration & dosage
  • Methylprednisolone / therapeutic use
  • Pristinamycin* / administration & dosage
  • Pristinamycin* / adverse effects
  • Stevens-Johnson Syndrome* / drug therapy
  • Stevens-Johnson Syndrome* / etiology

Substances

  • Pristinamycin
  • Anti-Bacterial Agents
  • Methylprednisolone