Stevens-Johnson Syndrome (SJS) is a rare but serious side effect of the antibiotic Zithromax. It can cause a life-threatening skin rash, blisters, infections, blindness, and death.
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Zithromax and Stevens-Johnson Syndrome (SJS)
Zithromax (azithromycin) is a very commonly-prescribed antibiotic. In very rare cases, it can cause serious allergic skin reactions. Patients on Zithromax have reported Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). Fatalities have also been reported.
What is the problem?
Zithromax has a long tissue half-life. On average, it takes 68 hours (nearly 3 days) for the body to eliminate half of a 500-mg dose of Zithromax. This allows a large single dose to be administered, but when allergic reactions occur, it prolongs exposure and potential risks.
Case Reports Linking Zithromax and SJS
Five case reports linking Zithromax and SJS have been published as of March 2016. In one case report, a 58 year-old man developed a severe skin rash due to SJS after taking Zithromax for 5 days. He had blisters with skin detachment and oozing fluid. He was admitted to the burn unit for further care.
In another case report from 2006, a 62 year-old woman was diagnosed with SJS after taking Zithromax for 10 days. The rash progressed from her palms to her feet and eyes. It was accompanied by fever and chills. After treatment with anti-inflammatory corticosteroids, her condition improved in several days.
What is SJS?
Stevens-Johnson Syndrome (SJS) is a severe skin reaction that is usually triggered by allergic reactions to medications. When the rash covers at least 30% of the skin, SJS is called Toxic Epidermal Necrolysis (TEN). SJS and TEN are the same disease. When SJS is mild and caused by infections, it is called erythema multiforme. TEN is also known as Lyell’s syndrome after the doctor who discovered it.
Warning Signs of SJS and TEN
SJS and TEN begin with flu-like symptoms and a burning skin rash that worsens for a few days. Inflammation occurs in the mucous membranes (eyes, mouth, nose, genitals, lungs, intestines). Large fluid-filled blisters develop. The top layer of skin dies and peels off.
Symptoms of SJS
- Rash, blisters, or red patches on skin
- Persistent fever
- Blisters on the skin and mucous membranes
- Swelling of eyes, red eyes
- Flu-like symptoms
Complications of SJS and TEN include infections, pneumonia, organ failure, blindness, dry-eye syndrome, lung damage, loss of hair and nails, genital scarring, and skin disfigurement. SJS is deadly in 5-10% of cases. TEN is deadly in 25-50% of cases, even with treatment.
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