JAMA Dermatology

<jats:sec id="ab-doi240005-4"><jats:title>Importance</jats:title><jats:p>Dermatologists prescribe more oral antibiotics per clinician than clinicians in any other specialty. Despite clinical guidelines that recommend limitation of long-term oral antibiotic treatments for acne to less than 3 months, there is little evidence to guide the design and implementation of an antibiotic stewardship program in clinical practice.</jats:p></jats:sec><jats:sec id="ab-doi240005-5"><jats:title>Objective</jats:title><jats:p>To identify salient barriers and facilitators to long-term antibiotic prescriptions for acne treatment.</jats:p></jats:sec><jats:sec id="ab-doi240005-6"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This qualitative study assessed data collected from stakeholders (including dermatologists, infectious disease physicians, dermatology resident physicians, and nonphysician clinicians) via an online survey and semistructured video interviews between March and August 2021. Data analyses were performed from August 12, 2021, to January 20, 2024.</jats:p></jats:sec><jats:sec id="ab-doi240005-7"><jats:title>Main Outcomes and Measures</jats:title><jats:p>Online survey and qualitative video interviews developed with the Theoretical Domains Framework. Thematic analyses were used to identify salient themes on barriers and facilitators to long-term antibiotic prescriptions for acne treatment.</jats:p></jats:sec><jats:sec id="ab-doi240005-8"><jats:title>Results</jats:title><jats:p>Among 30 participants (14 [47%] males and 16 [53%] females) who completed the study requirements and were included in the analysis, knowledge of antibiotic guideline recommendations was high and antibiotic stewardship was believed to be a professional responsibility. Five salient themes were to be affecting long-term antibiotic prescriptions: perceived lack of evidence to justify change in dermatologic practice, difficulty navigating patient demands and satisfaction, discomfort with discussing contraception, iPLEDGE-related barriers, and the absence of an effective system to measure progress on antibiotic stewardship.</jats:p></jats:sec><jats:sec id="ab-doi240005-9"><jats:title>Conclusions and Relevance</jats:title><jats:p>The findings of this qualitative study indicate that multiple salient factors affect long-term antibiotic prescribing practices for acne treatment. These factors should be considered in the design and implementation of any future outpatient antibiotic stewardship program for clinical dermatology.</jats:p></jats:sec>

Staphylococcus aureus carriage rates and antibiotic resistance patterns in patients with acne vulgaris.

J Am Acad Dermatol

Is there an association between long-term antibiotics for acne and subsequent infection sequelae and antimicrobial resistance? A systematic review.

BJGP Open

Effect of antibiotics on the oropharyngeal flora in patients with acne.

Arch Dermatol

Antibiotic treatment of acne may be associated with upper respiratory tract infections.

Association of pharyngitis with oral antibiotic use for the treatment of acne: a cross-sectional and prospective cohort study.

Potential association between the oral tetracycline class of antimicrobials used to treat acne and inflammatory bowel disease.

Am J Gastroenterol

Antibiotic use in relation to the risk of breast cancer.

JAMA

Frequent use of antibiotics is associated with colorectal cancer risk: results of a nested case-control study.

Dig Dis Sci

Guidelines of care for the management of acne vulgaris.

Trends in oral antibiotic prescription in dermatology, 2008 to 2016.

JAMA Dermatol

A retrospective analysis of the duration of oral antibiotic therapy for the treatment of acne among adolescents: investigating practice gaps and potential cost-savings.

Duration of oral antibiotic therapy for the treatment of adult acne: a retrospective analysis investigating adherence to guideline recommendations and opportunities for cost-savings.

Status report from the American Acne & Rosacea Society on medical management of acne in adult women, part 3: oral therapies.

Cutis

Core elements of outpatient antibiotic stewardship.

MMWR Recomm Rep

Developing and implementing approaches to limit antimicrobial resistance.

A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems.

Implement Sci

Using thematic analysis in psychology.

Qual Res Psychol

The behaviour change wheel: a new method for characterising and designing behaviour change interventions.

Code saturation versus meaning saturation: how many interviews are enough?

Qual Health Res

Sample sizes for saturation in qualitative research: a systematic review of empirical tests.

Soc Sci Med

Executive summary: implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America.

Clin Infect Dis

Status report from the scientific panel on antibiotic use in dermatology of the American Acne and Rosacea Society: part 1, antibiotic prescribing patterns, sources of antibiotic exposure, antibiotic consumption and emergence of antibiotic resistance, impact of alterations in antibiotic prescribing, and clinical sequelae of antibiotic use.

J Clin Aesthet Dermatol

Characterization of acne patients carrying clindamycin-resistant Cutibacterium acnes: a Japanese multicenter study.

J Dermatol

C. acnes qPCR-based Antibiotics Resistance Assay (ACQUIRE) reveals widespread macrolide resistance in acne patients and can eliminate macrolide misuse in acne treatment.

Front Public Health

The extinction of topical erythromycin therapy for acne vulgaris and concern for the future of topical clindamycin.

J Dermatolog Treat

Antibiotic resistant Cutibacterium acnes among acne patients in Jordan: a cross sectional study.

BMC Dermatol

Alterations of human skin microbiome and expansion of antimicrobial resistance after systemic antibiotics.

Sci Transl Med

Comparison of five antimicrobial regimens for treatment of mild to moderate inflammatory facial acne vulgaris in the community: randomised controlled trial.

Lancet

Effectiveness of spironolactone for women with acne vulgaris (SAFA) in England and Wales: pragmatic, multicentre, phase 3, double blind, randomised controlled trial.

Patient awareness of antimicrobial resistance and antibiotic use in acne vulgaris.

Are patient views about antibiotics related to clinician perceptions, management and outcome? a multi-country study in outpatients with acute cough.

PLoS One

Ruling out the need for antibiotics: are we sending the right message?

Arch Pediatr Adolesc Med

Patient satisfaction remains unchanged following implementation of an antibiotic stewardship intervention in primary care.

Open Forum Infect Dis

Patient satisfaction not impacted by antibiotic prescribing for viral upper respiratory infections.

Adherence to oral contraception in women on category X medications.

Am J Med

Isotretinoin and oral contraceptive use in female acne patients varies by physician specialty: analysis of data from the National Ambulatory Medical Care Survey.

Women’s experiences with isotretinoin risk reduction counseling.

Promoting safe use of isotretinoin by increasing contraceptive knowledge.

Threats to evidence-based care with teratogenic medications in states with abortion restrictions.

The Supreme Court abortion ban impact on dermatology.

Isotretinoin: update on controversial issues.

J Pediatr Adolesc Gynecol

Isotretinoin, patient safety, and patient-centered care-time to reform iPLEDGE.

Personal burden of isotretinoin therapy and willingness to pay for electronic follow-up visits.

Simplifying contraception requirements for iPLEDGE: a decision analysis.

Telemedicine and home pregnancy testing for iPLEDGE: a survey of clinician perspectives.

The future of iPLEDGE: We pledge for more inclusive access to isotretinoin.

Pediatr Dermatol

Antimicrobial stewardship in outpatient settings: a systematic review.

Infect Control Hosp Epidemiol

Training family physicians in shared decision-making to reduce the overuse of antibiotics in acute respiratory infections: a cluster randomized trial.

CMAJ

Training family physicians in shared decision making for the use of antibiotics for acute respiratory infections: a pilot clustered randomized controlled trial.

Health Expect

Effects of clinical pathways for common outpatient infections on antibiotic prescribing.

Nudging guideline-concordant antibiotic prescribing: a randomized clinical trial.

JAMA Intern Med

Effect of an outpatient antimicrobial stewardship intervention on broad-spectrum antibiotic prescribing by primary care pediatricians: a randomized trial.

Antimicrobial stewardship metrics: prospective audit with intervention and feedback.

R I Med J

Effects of behavioral interventions on inappropriate antibiotic prescribing in primary care 12 months after stopping interventions.

Exploring antimicrobial stewardship influential interventions on improving antibiotic utilization in outpatient and inpatient settings: a systematic review and meta-analysis.

Antibiotics (Basel)

Development and initial validation of the influences on patient safety behaviours questionnaire.

European evidence-based (S3) guideline for the treatment of acne - update 2016-short version.

J Eur Acad Dermatol Venereol

Consensus-based acne classification system and treatment algorithm for Spain.

Actas Dermosifiliogr

New NICE guidance on acne vulgaris: implications for first-line management in primary care.

Br J Gen Pract

Japanese Dermatological Association Guidelines: guidelines for the treatment of acne vulgaris, 2017.

FASCE, the benefit of spironolactone for treating acne in women: study protocol for a randomized double-blind trial.

Trials

Optimizing the trial design for a comparative effectiveness study of spironolactone versus oral antibiotics for women with acne: a Delphi consensus Panel.

J Drugs Dermatol

Frequency of treatment switching for spironolactone compared to oral tetracycline-class antibiotics for women with acne: a retrospective cohort study 2010-2016.

Dermatologists prescribe more oral antibiotics per clinician than clinicians in any other specialty. Despite clinical guidelines that recommend limitation of long-term oral antibiotic treatments for acne to less than 3 months, there is little evidence to guide the design and implementation of an antibiotic stewardship program in clinical practice.
To identify salient barriers and facilitators to long-term antibiotic prescriptions for acne treatment.
This qualitative study assessed data collected from stakeholders (including dermatologists, infectious disease physicians, dermatology resident physicians, and nonphysician clinicians) via an online survey and semistructured video interviews between March and August 2021. Data analyses were performed from August 12, 2021, to January 20, 2024.
Online survey and qualitative video interviews developed with the Theoretical Domains Framework. Thematic analyses were used to identify salient themes on barriers and facilitators to long-term antibiotic prescriptions for acne treatment.
Among 30 participants (14 [47%] males and 16 [53%] females) who completed the study requirements and were included in the analysis, knowledge of antibiotic guideline recommendations was high and antibiotic stewardship was believed to be a professional responsibility. Five salient themes were to be affecting long-term antibiotic prescriptions: perceived lack of evidence to justify change in dermatologic practice, difficulty navigating patient demands and satisfaction, discomfort with discussing contraception, iPLEDGE-related barriers, and the absence of an effective system to measure progress on antibiotic stewardship.
The findings of this qualitative study indicate that multiple salient factors affect long-term antibiotic prescribing practices for acne treatment. These factors should be considered in the design and implementation of any future outpatient antibiotic stewardship program for clinical dermatology.

Barriers and Facilitators Affecting Long-Term Antibiotic Prescriptions for Acne Treatment.

Barriers and Facilitators Affecting Long-Term Antibiotic Prescriptions for Acne Treatment

<jats:sec id="ab-doi230075-4"><jats:title>Importance</jats:title><jats:p>Hidradenitis suppurativa (HS) is a debilitating follicular skin disorder in which bacterial colonization is typical. Oral antibiotic efficacy can be unreliable; however, selective intravenous antibiotics, specifically ertapenem, may provide favorable clinical outcomes.</jats:p></jats:sec><jats:sec id="ab-doi230075-5"><jats:title>Objective</jats:title><jats:p>To explore optimal course duration, efficacy, and patient satisfaction associated with intravenous ertapenem for HS.</jats:p></jats:sec><jats:sec id="ab-doi230075-6"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This retrospective review of the medical records of 98 patients with HS between 2018 and 2022 measured and evaluated patient outcomes before and after treatment with intravenous ertapenem. Participants were followed up in a telephone survey assessing patient perspectives and satisfaction. All of those included in this study received medical care from the Albert Einstein College of Medicine’s Montefiore HS Center.</jats:p></jats:sec><jats:sec id="ab-doi230075-7"><jats:title>Exposures</jats:title><jats:p>Patients were treated with 1 g of ertapenem that was self-administered at home through a peripheral intravenous central catheter using an elastomeric pump for 12 to 16 weeks. Antiandrogens and immunomodulatory biologic therapies initiated prior to ertapenem were maintained throughout the treatment course.</jats:p></jats:sec><jats:sec id="ab-doi230075-8"><jats:title>Main Outcomes and Measures</jats:title><jats:p>The primary outcomes, encompassing clinical severity (evaluated through the HS Physician Global Assessment score [a 6-point scale ranging from clear to very severe] and a numerical rating scale for pain [an 11-point scale in which a score of 0 indicates no pain and a score of 10 indicates the worst possible pain]) and markers of inflammation (such as leukocytes, erythrocyte sedimentation rate, C-reactive protein, and interleukin-6), were measured at baseline, the midcourse of intravenous ertapenem treatment, at the end of the course, and posttherapy. Bacterial abundance was also examined at these 4 points, and patient satisfaction was assessed during follow-up.</jats:p></jats:sec><jats:sec id="ab-doi230075-9"><jats:title>Results</jats:title><jats:p>A total of 98 patients (mean [SD] age, 35.8 [13.0] years; 61 [62.2%] female) with HS were treated with intravenous ertapenem. The self-reported racial distribution included 3 individuals identifying as Asian (3.1%), 59 as Black/African American (60.2%), 13 as White (13.3%), and 23 as either other or unknown (23.5%). Additionally, 24 participants (24.5%) reported Spanish/Hispanic/Latino ethnicity. The mean (SD) treatment duration spanned 13.1 (4.0) weeks, with posttherapy follow-up occurring after 7.8 (3.6) weeks. From baseline to posttherapy follow-up, significant reductions were found in the mean (SD) HS Physician Global Assessment scores (3.9 [1.0] vs 2.7 [1.2]; <jats:italic>P</jats:italic> &amp;amp;lt; .001) and the numerical rating scale for pain (4.2 [3.3] vs 1.8 [2.7]; <jats:italic>P</jats:italic> &amp;amp;lt; .001), C-reactive protein (5.4 [11.4] vs 2.4 [2.0] mg/dL; <jats:italic>P</jats:italic> &amp;amp;lt; .001), interleukin-6 (25.2 [21.1] vs 13.7 [13.9]; <jats:italic>P</jats:italic> &amp;amp;lt; .001), and leukocytes (11.34 [3.9] vs 10.0 [3.4]; <jats:italic>P</jats:italic> &amp;amp;lt; .001). At follow-up, 76 patients (78.0%) participated in the telephone survey, where 63 (80.3%) reported medium to high satisfaction; further, 69 (90.8%) would recommend ertapenem to other patients.</jats:p></jats:sec><jats:sec id="ab-doi230075-10"><jats:title>Conclusions and Relevance</jats:title><jats:p>In this retrospective review of medical records and telephone survey, treating HS with intravenous ertapenem, administered for a mean of 13 weeks, was associated with improvement in clinical and inflammatory markers, as well as heightened patient satisfaction. Nonetheless, this approach should be monitored for the emergence of antimicrobial resistance given a longer than standard treatment course.</jats:p></jats:sec>

The handicap of hidradenitis suppurativa.

Dermatol Clin

Depression is a frequent co-morbidity in patients with acne inversa.

J Dtsch Dermatol Ges

North American Clinical Management Guidelines for hidradenitis suppurativa: a publication from the United States and Canadian Hidradenitis Suppurativa Foundations: part I: diagnosis, evaluation, and the use of complementary and procedural management.

European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa.

Hidradenitis suppurativa: a treatment challenge.

Am Fam Physician

Ertapenem: a review of its use in the management of bacterial infections.

Drugs

Efficacy of ertapenem in severe hidradenitis suppurativa: a pilot study in a cohort of 30 consecutive patients.

J Antimicrob Chemother

Ertapenem rescue therapy in hidradenitis suppurativa.

JAAD Case Rep

Ertapenem—a potent treatment for clinical and quality of life improvement in patients with hidradenitis suppurativa.

Int J Dermatol

14970 Short-lived efficacy of ertapenem for refractory hidradenitis suppurativa.

Adalimumab for the treatment of moderate to severe hidradenitis suppurativa: a parallel randomized trial.

Ann Intern Med

Intramuscular ertapenem for the treatment of severe cases hidradenitis suppurativa.

Serum inflammatory markers and leukocyte profiles accurately describe hidradenitis suppurativa disease severity.

North American Clinical Management Guidelines for hidradenitis suppurativa: a publication from the United States and Canadian Hidradenitis Suppurativa Foundations: part II: topical, intralesional, and systemic medical management.

The microbiome in hidradenitis suppurativa: a review.

Dermatol Ther (Heidelb)

Hidradenitis suppurativa (HS) is a debilitating follicular skin disorder in which bacterial colonization is typical. Oral antibiotic efficacy can be unreliable; however, selective intravenous antibiotics, specifically ertapenem, may provide favorable clinical outcomes.
To explore optimal course duration, efficacy, and patient satisfaction associated with intravenous ertapenem for HS.
This retrospective review of the medical records of 98 patients with HS between 2018 and 2022 measured and evaluated patient outcomes before and after treatment with intravenous ertapenem. Participants were followed up in a telephone survey assessing patient perspectives and satisfaction. All of those included in this study received medical care from the Albert Einstein College of Medicine's Montefiore HS Center.
Patients were treated with 1 g of ertapenem that was self-administered at home through a peripheral intravenous central catheter using an elastomeric pump for 12 to 16 weeks. Antiandrogens and immunomodulatory biologic therapies initiated prior to ertapenem were maintained throughout the treatment course.
The primary outcomes, encompassing clinical severity (evaluated through the HS Physician Global Assessment score [a 6-point scale ranging from clear to very severe] and a numerical rating scale for pain [an 11-point scale in which a score of 0 indicates no pain and a score of 10 indicates the worst possible pain]) and markers of inflammation (such as leukocytes, erythrocyte sedimentation rate, C-reactive protein, and interleukin-6), were measured at baseline, the midcourse of intravenous ertapenem treatment, at the end of the course, and posttherapy. Bacterial abundance was also examined at these 4 points, and patient satisfaction was assessed during follow-up.
A total of 98 patients (mean [SD] age, 35.8 [13.0] years; 61 [62.2%] female) with HS were treated with intravenous ertapenem. The self-reported racial distribution included 3 individuals identifying as Asian (3.1%), 59 as Black/African American (60.2%), 13 as White (13.3%), and 23 as either other or unknown (23.5%). Additionally, 24 participants (24.5%) reported Spanish/Hispanic/Latino ethnicity. The mean (SD) treatment duration spanned 13.1 (4.0) weeks, with posttherapy follow-up occurring after 7.8 (3.6) weeks. From baseline to posttherapy follow-up, significant reductions were found in the mean (SD) HS Physician Global Assessment scores (3.9 [1.0] vs 2.7 [1.2]; P < .001) and the numerical rating scale for pain (4.2 [3.3] vs 1.8 [2.7]; P < .001), C-reactive protein (5.4 [11.4] vs 2.4 [2.0] mg/dL; P < .001), interleukin-6 (25.2 [21.1] vs 13.7 [13.9]; P < .001), and leukocytes (11.34 [3.9] vs 10.0 [3.4]; P < .001). At follow-up, 76 patients (78.0%) participated in the telephone survey, where 63 (80.3%) reported medium to high satisfaction; further, 69 (90.8%) would recommend ertapenem to other patients.
In this retrospective review of medical records and telephone survey, treating HS with intravenous ertapenem, administered for a mean of 13 weeks, was associated with improvement in clinical and inflammatory markers, as well as heightened patient satisfaction. Nonetheless, this approach should be monitored for the emergence of antimicrobial resistance given a longer than standard treatment course.

Efficacy and Durability of Intravenous Ertapenem Therapy for Recalcitrant Hidradenitis Suppurativa.

Efficacy and Durability of Intravenous Ertapenem Therapy for Recalcitrant Hidradenitis Suppurativa

<jats:sec id="ab-doi220074-4"><jats:title>Importance</jats:title><jats:p>Antibiotics are an important risk for Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN), which are the most severe types of drug hypersensitivity reaction with a mortality rate up to 50%. To our knowledge, no global systematic review has described antibiotic-associated SJS/TEN.</jats:p></jats:sec><jats:sec id="ab-doi220074-5"><jats:title>Objective</jats:title><jats:p>To evaluate the prevalence of antibiotics associated with SJS/TEN worldwide.</jats:p></jats:sec><jats:sec id="ab-doi220074-6"><jats:title>Data Sources</jats:title><jats:p>The MEDLINE and Embase databases were searched for experimental and observational studies that described SJS/TEN risks since database inception to February 22, 2022.</jats:p></jats:sec><jats:sec id="ab-doi220074-7"><jats:title>Study Selection</jats:title><jats:p>Included studies adequately described SJS/TEN origins and specified the antibiotics associated with SJS/TEN.</jats:p></jats:sec><jats:sec id="ab-doi220074-8"><jats:title>Data Extraction and Synthesis</jats:title><jats:p>Two reviewers (E.Y.L. and C.K.) independently selected the studies, extracted the data, and assessed the risk of bias. A meta-analysis using a random-effects model was performed in the studies that described patient-level associations. Subgroup analyses were performed to explore the heterogeneity. The risk of bias was assessed using the Joanna Briggs Institute checklist, and the certainty of evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.</jats:p></jats:sec><jats:sec id="ab-doi220074-9"><jats:title>Main Outcomes and Measures</jats:title><jats:p>Prevalence of antibiotic-associated SJS/TEN was presented as pooled proportions with 95% CIs.</jats:p></jats:sec><jats:sec id="ab-doi220074-10"><jats:title>Results</jats:title><jats:p>Among the 64 studies included in the systematic review, there were 38 studies that described patient-level associations; the meta-analysis included these 38 studies with 2917 patients to determine the prevalence of single antibiotics associated with SJS/TEN. The pooled proportion of antibiotics associated with SJS/TEN was 28% (95% CI, 24%-33%), with moderate certainty of evidence. Among antibiotic-associated SJS/TEN, the sulfonamide class was associated with 32% (95% CI, 22%-44%) of cases, followed by penicillins (22%; 95% CI, 17%-28%), cephalosporins (11%; 95% CI, 6%-17%), fluoroquinolones (4%; 95% CI, 1%-7%), and macrolides (2%; 95% CI, 1%-5%). There was a statistically significant heterogeneity in the meta-analysis, which could be partially explained in the subgroup analysis by continents. The overall risk of bias was low using the Joanna Briggs Institute checklist for case series.</jats:p></jats:sec><jats:sec id="ab-doi220074-11"><jats:title>Conclusion and Relevance</jats:title><jats:p>In this systematic review and meta-analysis of all case series, antibiotics were associated with more than one-quarter of SJS/TEN cases described worldwide, and sulfonamide antibiotics remained the most important association. These findings highlight the importance of antibiotic stewardship, clinician education and awareness, and weighing the risk-benefit assessment of antibiotic choice and duration.</jats:p></jats:sec>

Drug causality in Stevens-Johnson syndrome/toxic epidermal necrolysis in Europe: analysis of 10 years RegiSCAR-Study.

Pharmacoepidemiol Drug Saf

Morbidity and mortality of Stevens-Johnson syndrome and toxic epidermal necrolysis in United States adults.

J Invest Dermatol

The epidemiology of Stevens-Johnson syndrome and toxic epidermal necrolysis in the UK.

Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme.

Long-term physical and psychological outcomes of Stevens-Johnson syndrome/toxic epidermal necrolysis.

Stevens-Johnson syndrome and toxic epidermal necrolysis: assessment of medication risks with emphasis on recently marketed drugs: the EuroSCAR-study.

Clinical, etiologic, and histopathologic features of Stevens-Johnson syndrome during an 8-year period at Mayo Clinic.

Mayo Clin Proc

ALDEN, an algorithm for assessment of drug causality in Stevens-Johnson syndrome and toxic epidermal necrolysis: comparison with case-control analysis.

Clin Pharmacol Ther

Stevens-Johnson syndrome and toxic epidermal necrolysis standard reporting and evaluation guidelines: results of a National Institutes of Health working group.

The current understanding of Stevens-Johnson syndrome and toxic epidermal necrolysis.

Expert Rev Clin Immunol

Recurrence and mortality following severe cutaneous adverse reactions.

Comprehensive survival analysis of a cohort of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis.

Trends in outpatient antibiotic use and prescribing practice among US older adults, 2011-15: observational study.

Histopathological and epidemiological characteristics of patients with erythema exudativum multiforme major, Stevens-Johnson syndrome and toxic epidermal necrolysis.

Br J Dermatol

Toxic epidermal necrolysis: Part II. Prognosis, sequelae, diagnosis, differential diagnosis, prevention, and treatment.

Central limit theorem: the cornerstone of modern statistics.

Korean J Anesthesiol

GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.

Review of culprit drugs associated with patients admitted to the burn unit with the diagnosis of Stevens-Johnson syndrome and toxic epidermal necrolysis syndrome.

Burns

Toxic epidermal necrolysis and Stevens-Johnson syndrome/toxic epidermal necrolysis overlap in pediatric patients with a focus on newer antiepileptic drugs: a 25-year retrospective study at a single tertiary care center.

Retrospective study of patients with SJS/TEN treated at a tertiary burn unit in Canada: overview of 17 years of treatment.

J Cutan Med Surg

A retrospective, 5-year, clinicoepidemiological study of severe cutaneous adverse reactions (SCARs).

Factors predicting the outcome in Stevens-Johnson syndrome and toxic epidermal necrolysis: a retrospective study over a 5-year period.

Severe cutaneous adverse drug reactions: incidence, clinical patterns, causative drugs and modalities of treatment in Assiut University Hospital, Upper Egypt.

Dermatol Ther

The link between HLA-B alleles and causative drugs in Vietnamese patients with Stevens-Johnson syndrome/toxic epidermal necrolysis.

Open Access Maced J Med Sci

Retrospective study of 213 cases of Stevens-Johnson syndrome and toxic epidermal necrolysis from China.

Stevens-Johnson syndrome and toxic epidermal necrolysis: a retrospective descriptive study.

A 10-year retrospective cohort study of the management of toxic epidermal necrolysis and Stevens-Johnson syndrome in a New South Wales state referral hospital from 2006 to 2016.

Ocular and mucocutaneous sequelae among survivors of Stevens-Johnson syndrome and toxic epidermal necrolysis in Togo.

Dermatol Res Pract

Stevens-Johnson syndrome and toxic epidermal necrolysis: retrospective review of 10-year experience.

Causative factors and clinical outcome in Steven Johnson syndrome and toxic epidermal necrolysis.

J Postgrad Med Inst

Drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in children: 20 years study in a tertiary care hospital.

World J Pediatr

Genitourinary involvement and management in children with Stevens-Johnson syndrome and toxic epidermal necrolysis.

J Pediatr Urol

Retrospective analysis of Stevens-Johnson syndrome and toxic epidermal necrolysis in 88 Chinese patients.

Chin Med J (Engl)

Steven Johnson syndrome and toxic epidermal necrolysis in a burn unit: a 15-year experience.

Stevens-Johnson syndrome and toxic epidermal necrolysis: an analysis of triggers and implications for improving prevention.

Severe cutaneous adverse drug reactions in pediatric patients: a multicenter study.

J Allergy Clin Immunol Pract

Stevens-Johnson syndrome and toxic epidermal necrolysis in Dr. Hasan Sadikin General Hospital Bandung, Indonesia from 2009-2013.

Asia Pac Allergy

Risk factors and mortality among patients with severe muco-cutaneous drug reactions.

Dan Med J

A 15-year review of pediatric toxic epidermal necrolysis.

J Burn Care Res

Stevens-Johnson syndrome and toxic epidermal necrolysis: a multi-aspect comparative 7-year study from the People’s Republic of China.

Drug Des Dev Ther

Stevens-Johnson syndrome and toxic epidermal necrolysis: a 20-year single-center experience.

Stevens-Johnson syndrome and toxic epidermal necrolysis in sub-Saharan Africa: a multicentric study in four countries.

An epidemiological and clinical analysis of cutaneous adverse drug reactions seen in a tertiary hospital in Johor, Malaysia.

Indian J Dermatol Venereol Leprol

Toxic epidermal necrolysis: five years of treatment experience from a burn unit.

Worldwide Prevalence of Antibiotic-Associated Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Papers