Risk factors for adverse cutaneous drug reactions in the therapy of erysipelas. An analytical epidemiological study

Antibiotic therapy of erysipelas is often complicated by adverse cutaneous drug reactions. In the present study we examined whether cutaneous drug eru ptions are more common in patients treated with penicillin than in those tr eated with other antibiotics, and whether certain risk factors for the deve lopment of a cutaneous drug eruption can be identified in patients treated with penicillin. In a retrospective analysis of 993 in-patients treated for erysipelas, 70 had developed a cutaneous drug eruption. Drug eruptions wer e significantly more common in patients treated with penicillin than in oth er patients (relative risk ratio 10.4, 95% confidence interval 1.4 - 75.6). In patients treated with penicillin, laboratory parameters indicating seve re inflammation, local complications of the erysipelas and the additional a dministration of flucloxacillin or non-steroidal antiphlogistic drugs were associated with an increased risk of a cutaneous drug eruption. Our finding s suggest that in patients with severe and complicated erysipelas antibioti c therapy other than penicillin should be considered. Furthermore, the addi tional administration of flucloxacillin and of non-steroidal antiphlogistic s should be avoided.