"Treating Through" Decision and Follow-up in Antibiotic Therapy-Associated Exanthemas

The Journal of Allergy and Clinical Immunology. in Practice
Axel TrautmannJohanna Stoevesandt

Abstract

Immediate discontinuation or replacement of suspected drugs is considered standard medical care in acute exanthematous skin reactions. In the treatment of bacterial infections, structurally different alternative antibiotics, however, are commonly second choice options due to a suboptimal antimicrobial activity or an unfavorable side effect profile. Nonetheless, "treating through," the continuation of antibiotic treatment despite an objective exanthema, is practiced only rarely. We aimed to assess whether "treating through" is an option for patients with severe bacterial soft tissue infections (severe cellulitis) who experience maculopapular exanthema (MPE) during antibiotic therapy. We retrospectively reviewed clinical data from 18 patients who developed MPE within a few days after initiation of intravenous antibiotic treatment. A decision to "treat through" was made when the suspected antibiotics (β-lactams, clindamycin, ciprofloxacin) were clinically effective and the benefits of continued treatment outweighed potential risks. Clinical and laboratory findings were closely monitored in an inpatient setting. In 2 patients, a modification of antibiotic therapy was deemed necessary due to a significant increase of liver enzymes w...Continue Reading

Citations

May 29, 2019·Current Opinion in Allergy and Clinical Immunology·Knut Brockow, Wolfgang Pfützner
Jun 14, 2019·The Pediatric Infectious Disease Journal·Francesca MoriElio Novembre
Dec 10, 2020·Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology·Philipp SchrüferAxel Trautmann
Oct 12, 2020·The Journal of Allergy and Clinical Immunology. in Practice·Rannakoe J LehloenyaElizabeth J Phillips
Apr 21, 2021·The Journal of Allergy and Clinical Immunology. in Practice·Jason A TrubianoAxel Trautmann
Dec 24, 2018·The Journal of Allergy and Clinical Immunology·Elizabeth J PhillipsAnnick Barbaud
Jun 3, 2021·Current Opinion in Allergy and Clinical Immunology·Javier FernandezNatalia Blanca-Lopez
Nov 13, 2021·Clinical Reviews in Allergy & Immunology·Ellen MinaldiAllison Norton

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