Drug Reaction

Abstract

A 44-year-old male patient presented to Primary Care with a diffuse morbilliform rash that began the day following the end of a 7-day course of amoxicillin. The patient was treated for an acute drug eruption. Drug-induced eruptions are one of the most common adverse events associated with using medication, with hives and rashes being their most common manifestation. The oral medications most frequently associated with drug eruptions are antibiotics, anticonvulsants, and nonsteroidal anti-inflammatories. These medications are also associated with the life-threatening conditions Stevens–Johnson syndrome, toxic epidermal necrolysis, and erythema multiforme major, which can be excluded in the absence of systemic involvement such as fever, sore throat, and fatigue. The most important part of treatment of common morbilliform eruptions, as the one in this patient’s case, is discontinuation of the offending medication. This usually leads to symptom resolution within 2 weeks. Antihistamines may be given if patients are particularly pruritic and/or itching interrupts their sleep. Fifteen-day tapered courses of systemic corticosteroids help to resolve rashes quickly; however, they are controversial as they sometimes lead to rebound rashes.