哌拉西林钠他唑巴坦钠致Stevens-Johnson综合征1例

One case of Stevens-Johnson syndrome caused by piperacillin sodium and tazobactam sodium

1例68岁男性患者,因急性胰腺炎入院治疗。静脉给予莫西沙星注射液(0.4 g,qd)治疗17 d,为减少耐药风险,将莫西沙星换用为哌拉西林钠他唑巴坦钠(4.5 g,q 8 h)。3 d后,患者出现重症多形红斑型药疹,停药并先后给予地塞米松磷酸钠(10 mg,qd)、甲泼尼龙琥珀酸钠(40 mg,qd)、丙种人免疫球蛋白(10 g,qd)等抗过敏治疗。15 d后,患者全身未见新发皮疹,四肢皮疹逐渐隐退,面部及颈部皮肤脱屑后露出新生表皮,背部、臀部大面积表皮破损及表面渗出减少,疼痛与瘙痒消失,口唇黏膜糜烂愈合。

A 68-year-old male patient was hospitalized for acute pancreatitis. Moxifloxacin injection (0.4 g, qd) was given intravenously for 17 d. To reduce the risk of drug resistance, moxifloxacin was replaced with piperacillin sodium and tazobactam sodium (4.5 g, q 8 h). Three days later, the patient developed severe polymorphic erythematous drug eruption. Piperacillin sodium and tazobactam sodium was discontinued, and the patient was successively given antiallergic treatment including dexamethasone sodium phosphate (10 mg, qd), methylprednisolone sodium succinate (40 mg, qd), and human immunoglobulin (10 g, qd). After 15 days, there was no new rash in the patient's whole body, and the rash on the limbs gradually receded. The skin on the face and neck desquamated and new epidermis was exposed. The most of the skin damage and surface exudation on the back and buttocks were reduced. The pain and itching disappeared, and the erosion of the lip mucosa healed.