抗菌药物致中毒性表皮坏死松解症1例  

One Case of Toxic Epidermal Necrolysis Induced by Antibacterial Drugs

作　　者：罗晓枫 杜倩 奚鑫 冉海龙 LUO Xiaofeng;DU Qian;XI Xin;RAN Hailong(School of Pharmacy,Chongqing Medical University,Chongqing 400016,China;Department of Pharmacy,the Third Affiliated Hospital of Chongqing Medical University(Gener Hospital),Chongqing 401120,China)

机构地区：[1]重庆医科大学药学院,重庆400016 [2]重庆医科大学附属第三医院(捷尔医院)药剂科,重庆401120

出　　处：《中国药物警戒》2020年第8期535-538,共4页Chinese Journal of Pharmacovigilance

摘　　要：目的提醒临床医生在使用抗菌药物时应密切关注用药安全。方法分析1例45岁男性患者先后静脉滴注哌拉西林他唑巴坦、亚胺培南西司他丁、左氧氟沙星后出现中毒性表皮坏死松解症(TEN)的病例资料,文献回顾TEN的发病机制和治疗措施。结果该患者由哌拉西林他唑巴坦、亚胺培南西司他丁、左氧氟沙星引起TEN的可能性大,经过及时停药,积极抗过敏、系统免疫治疗及对症支持治疗后,患者皮肤症状逐渐缓解。结论哌拉西林他唑巴坦、亚胺培南西司他丁、左氧氟沙星致TEN的发生率低,但病死率高,预后差,应引起临床重视。Objective To remind the medical staff to pay close attention to medication safety of antibacterial drugs. Methods One case of toxic epidermal necrolysis(TEN) after intravenous infusion of piperacillin tazobactam, imipenem/cilastatin, and levofloxacin in a 45-year-old male patient was analyzed while literature about the pathogenesis and treatment of TEN was reviewed. Results Toxic epidermal necrolysis was most likely to be induced by piperacillin tazobactam, imipenem/cilastatin, and levofloxacin in this patient. The symptoms on the patient’s skin were relieved gradually via timely discontinuation of the drugs, anti-allergic therapy, systemic immunotherapy, and symptomatic supportive treatment. Conclusion Toxic epidermal necrolysis induced by piperacillin tazobactam, imipenem/cilastatin, and levofloxacin is a disease with low incidence, but with a high mortality and poor prognosis, which deserves attention.

关 键 词：哌拉西林钠他唑巴坦 亚胺培南西司他丁 左氧氟沙星 中毒性表皮坏死松懈症 

分 类 号：R994.11[医药卫生—毒理学]