title: Microbiological findings and antibacterial therapy in Stevens-Johnson syndrome/toxic epidermal necrolysis patients from a Swedish Burn Center.
abstract: BACKGROUND
  Superimposed infections/sepsis are the major cause of morbidity/mortality in Stevens-Johnson syndrome/Toxic Epidermal Necrolysis (SJS/TEN). It is a delicate balance between avoiding new pharmaceuticals and prophylactically treat an incipient infection. The objective of this study was to investigate the rates and types of infection-microbials and antibiotics involved in SJS/TEN patients.
  
  
  METHODS
  Microbiology and clinical data were collected for SJS/TEN patients admitted to our Burn Center from January 2010 through January 2016.
  
  
  RESULTS
  A total of 24 patients were admitted over the study period. There were 303 bacterial cultures taken whereof 113 (37.3%) were positive (median of 4.4 per patient). Twenty-two (91.7%) patients had at least 1 positive sample recorded. Fifteen (62.5%) patients had a confirmed episode of sepsis with skin being the most common source of colonization (77.8%). Eleven (45.8%) patients received empiric antibiotic therapy at referral facility/prior to admission to our Center. Patients who grew a higher number of different species were significantly less likely to have received early empiric antimicrobial therapy (P < .001).
  
  
  CONCLUSIONS
  Secondary bacterial infection and sepsis were a highly common finding in our patient population. Despite the risk of resistance and further immunological provocation, empirical antibiotic treatment might have a place in clinical management.
authors.affiliation: Uppsala Burn Centre, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Tocco-Tussardi
authors.affiliation: Uppsala Burn Centre, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Huss
authors.affiliation: Uppsala Burn Centre, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Presman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001419:Bacteria / Q000254:growth & development / Q000302:isolation & purification; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D002053:Burn Units; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013262:Stevens-Johnson Syndrome / Q000188:drug therapy / Q000382:microbiology; D013548:Sweden
chemical_list: D000900:Anti-Bacterial Agents
keywords: Stevens-Johnson syndrome; antibiotic therapy; bacterial infection; management; toxic epidermal necrolysis