Amoxicillin may rarely Induce acute generalized exanthematous pustulosis which may be self limiting
Source- Thienvibul C, Vachiramon V, Chanprapaph K. Five-Year Retrospective Review of Acute Generalized Exanthematous Pustulosis. Dermatol Res Pract. 2015;2015:260928. doi: 10.1155/2015/260928. Epub 2015 Dec 10. PMID: 26783390; PMCID: PMC4689982.
Amoxicillin, a commonly prescribed antibiotic, has been linked to an uncommon yet noteworthy skin reaction-Acute Generalized Exanthematous Pustulosis (AGEP). Despite its rarity, understanding the clinical characteristics is paramount for effective prevention and treatment. A recently conducted retrospective study delves into case reports and series to illuminate the landscape of amoxicillin-induced AGEP. The study found that AGEP induced by amoxicillin is a rare, self-limiting complication. Clinicians should be vigilant in recognizing AGEP and refrain from represcribing amoxicillin to avert unnecessary treatment measures.
This study was published in the journal of Dermatologic Therapy by Haibo Lei and colleagues. In this retrospective analysis of cases, a total of 46 patients were included, with a median age of 40 years (ranging from 1.4 to 87). The onset of acute generalized exanthematous pustulosis (AGEP) induced by amoxicillin varied widely, occurring between 6 hours to 28 days, with a median onset time of 2.5 days.
The key findings of the study were:
Patients with amoxicillin-induced acute generalized exanthematous pustulosis (AGEP) presented with various symptoms.
Fever was reported in 69.6% of cases, while pruritus affected 28.3% of patients.
Mucous membrane and systemic involvement were observed in 21.7% of individuals.
Laboratory findings revealed elevated neutrophil levels in 22 patients, with a median count of 12850/mm3 (range 7880 to 29140).
Skin biopsy results demonstrated diverse patterns, including subcorneal pustules (47.8%), spongy pustules (30.4%), and inflammatory cell infiltration (56.5%).
Upon discontinuation of amoxicillin, skin lesions resolved in a median of 10 days (range 2 to 42).
Treatment involved the use of topical steroids in 56.5% of cases and systemic corticosteroids in 28.3% of patients.
This study not only provides clinical insights but also emphasizes the importance of proper identification and management in cases of amoxicillin-induced AGEP.
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