tetracycline and Exanthema

Topics: Anaphylaxis; Angioedema; Anti-Bacterial Agents; Anti-Infective Agents; Carrier Proteins; Dose-Response Relationship, Drug; Drug Hypersensitivity; Exanthema; Humans; Hydrocortisone; Mast Cells; Peptides; Proteins; Serum Sickness; Skin Tests; Tetracycline; Urticaria

A review of the medical literature and two case reports of M. pneumoniae infections with exanthems are presented. Erythematous maculopapular and vesicular exanthems were most common. The duration of rash was more than seven days in the majority of instances, and most patients had associated pneumonia. A striking difference in prevalence and clinical symptomatology by sex was noted; 16 of 20 patients analyzed were males, and they frequently dad severe mucocutaneous syndromes. In contrast, severe conjunctivitis, generalized ulcerative stomatitis, and vesicular or bullous exanthems were not seen in females. Clinicians should suspect infection with M. pneumoniae in patients with exanthem and pneumonia, although other etiologic possibilities should also be considered.

Topics: Adolescent; Adult; Child; Child, Preschool; Complement Fixation Tests; Exanthema; Female; Humans; Male; Measles Vaccine; Mycoplasma Infections; Pneumonia; Radiography; Tetracycline

Epidermal growth factor receptor (EGFR) inhibitors are effective cancer therapies, but they are reported to cause a rash in >50% of patients. In the current study, the authors examined the use of tetracycline for rash prevention.. This placebo-controlled, double-blinded trial enrolled patients who were starting cancer treatment with an EGFR inhibitor. Patients could not have had a rash at the time of enrollment. All patients were randomly assigned to receive either tetracycline at a dose of 500 mg orally twice a day for 28 days versus a placebo. Patients were monitored for rash (through monthly physician assessment and weekly patient-reported questionnaires), quality of life (using the SKINDEX-16, a skin-specific quality of life index), and adverse events. Monitoring occurred during the 4-week intervention and then for an additional 4 weeks. The primary objective of the current study was to compare the incidence of rash between the study arms, and the enrollment of 30 patients per arm provided a 90% probability of detecting a 40% difference in incidence with a P value of .05 (2-sided).. A total of 61 evaluable patients were enrolled. The 2 treatment arms were well balanced with regard to baseline characteristics, dropout rates, and rates of discontinuation of the EGFR inhibitor. The incidence of rash was found to be comparable across treatment arms. Physicians reported that 16 patients treated with tetracycline (70%) and 22 patients treated with placebo (76%) developed a rash (P = .61). Tetracycline appears to have lessened the rash severity, although the high dropout rates invite caution when interpreting these findings. By Week 4, physician-reported grade 2 rash (using the National Cancer Institute's Common Terminology Criteria for Adverse Events [version 3.0]) occurred in 17% of tetracycline-treated patients (n = 4 patients) and in 55% of placebo-exposed patients (n = 16 patients) (P = .04). Patients treated with tetracycline reported better scores, as per the SKINDEX-16, on certain quality-of-life parameters such as skin burning or stinging, skin irritation, and being bothered by the persistence/recurrence of a skin condition. Adverse events were found to be comparable across treatment arms.. In the current study, tetracycline was not found to prevent EGFR inhibitor-induced rashes and therefore cannot be clinically recommended for this purpose. However, preliminary observations of diminished rash severity and improved quality of life suggest this antibiotic merits further study.

Topics: Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Cetuximab; Drug Evaluation; ErbB Receptors; Exanthema; Female; Gefitinib; Humans; Male; Middle Aged; Placebos; Quality of Life; Quinazolines; Tetracycline

The metronidazole resistance of Helicobacter pylori strains has increased rapidly.. To evaluate the efficacy and safety of new 1-week regimens containing ranitidine bismuth citrate, furazolidone and either amoxicillin or tetracycline.. One hundred and twenty patients with H. pylori-positive inactive duodenal ulcer or non-ulcer dyspepsia diagnosed by endoscopy were recruited randomly to receive one of two regimens for 7 days: ranitidine bismuth citrate, 350 mg b.d., furazolidone, 100 mg b.d., and either amoxicillin, 1000 mg b.d. (n=60), or tetracycline, 500 mg b.d. (n=60). H. pylori infection was identified by rapid urease testing and histology. 13C-Urea breath test was performed to evaluate the cure of H. pylori infection at least 4 weeks after completion of triple therapy.. The eradication rates of H. pylori by ranitidine bismuth citrate-furazolidone-amoxicillin and ranitidine bismuth citrate-furazolidone-tetracycline regimens were 82% and 85% (P > 0.05), respectively, by intention-to-treat analysis, and 85% and 91% (P > 0.05), respectively, by per protocol analysis. Adverse effects were mild in both ranitidine bismuth citrate-furazolidone-amoxicillin and ranitidine bismuth citrate-furazolidone-tetracycline groups.. One-week regimens containing ranitidine bismuth citrate, furazolidone and amoxicillin or tetracycline are well tolerated and effective for the eradication of H. pylori.

Topics: Adolescent; Adult; Aged; Amoxicillin; Anti-Bacterial Agents; Anti-Infective Agents, Local; Anti-Ulcer Agents; Bismuth; Diarrhea; Dizziness; Double-Blind Method; Drug Therapy, Combination; Exanthema; Female; Furazolidone; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Penicillins; Prospective Studies; Pruritus; Ranitidine; Tetracycline; Treatment Outcome; Vomiting

Epidermal growth factor receptor inhibitors (EGFRI) can be used with pathway inhibitors, including mitogen-activated protein kinase kinase inhibitors (MEKIs), BRAF inhibitors (BRAFIs), and checkpoint inhibitors such as programmed death-ligand 1 (PD-L1) and programmed cell death protein 1 (PD-1) to treat colorectal cancer. These can precipitate treatment-resistant acneiform eruptions, prompting dose modification or discontinuation. Predicting the likelihood of severe rash development and crafting effective treatments may promote adherence to life-saving chemotherapy.. An Institutional Review Board-approved retrospective chart review of patients with colorectal cancer treated with EGFRI or MEKI in combination with HER2, BRAF, PI3K, or checkpoint inhibitors between January 1, 2016, and January 1, 2020, was performed. Surrogates for rash severity were investigated, including lower extremity involvement, utilization of oral steroids or retinoids, dose modification, and incidence of superinfection.. Of 122 patients treated with combination therapy, 105 developed a rash, and 87 developed an acneiform eruption. Common combinations included MEKI/PD-LI, EGFRI/MEKI, and MEKI/PD-1I. Patients treated with EGFRI/MEKI developed the most severe rashes (p = 0.02). Lower extremity involvement was more frequent with EGFRI/MEKI compared to alternative combinations (p = 0.05). Drug holiday correlated with all rash severity surrogates, including rash grade, lower extremity involvement, oral steroid or retinoid use, and incidence of superinfection. Use of oral steroids or retinoids was associated with development of superinfection (p = 0.002). Prophylactic tetracycline use did not impact rash severity or rash incidence.. This is the first descriptive analysis to characterize acneiform eruptions for patients with colorectal cancer on combination cancer therapy. Approximately 85% of patients developed a cutaneous toxicity with what appears to be synergistic effects of EGFRI and MEKI combination therapy causing the most severe eruptions. Superinfection rate correlated to systemic therapy use beyond oral tetracyclines. Further investigation into the utility of prophylactic oral tetracyclines in this population is needed.

Topics: Acneiform Eruptions; Anti-Bacterial Agents; B7-H1 Antigen; Colorectal Neoplasms; ErbB Receptors; Exanthema; Humans; Mitogen-Activated Protein Kinase Kinases; Phosphatidylinositol 3-Kinases; Programmed Cell Death 1 Receptor; Protein Kinase Inhibitors; Proto-Oncogene Proteins B-raf; Retinoids; Retrospective Studies; Superinfection; Tetracycline

Topics: Anti-Bacterial Agents; Blister; Exanthema; Humans; Pemphigoid, Bullous; Tetracycline

Topics: Anti-Bacterial Agents; Exanthema; Humans; Pemphigoid, Bullous; Tetracycline

Historically, skin toxicity has been assessed in prospective clinical trials using the clinician-reported National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE). The patient-reported Skindex-16 measures symptoms and perceptions of toxicity. This study was designed to compare information provided by these two measures.. Data were compiled from three placebo-controlled North Central Cancer Treatment Group studies (N06C4, N03CB, N05C4) having rash prevention as the primary objective. All used the Skindex-16 and CTCAE at baseline, weekly during treatment and during a minimum 2-week follow-up period. Statistical procedures, including Pearson correlations, were utilized to determine relationships between adverse event (AE) grades and Skindex-16 scores.. Four hundred and twelve individual patients provided data (median age, 61; 134 male). Patients' Skindex-16 score results show a 0.9 overall mean (range 0-6 with 6 being worse symptoms), a 0.4 baseline mean (range, 0-4.3) and a 1.3 end-of-treatment mean (range, 0-5.9). Ninety-three, 142 and 177 patients experienced a grade 0, 1 and 2+ CTCAE skin toxicity, respectively. Baseline Skindex-16 scores had relatively low correlation with CTCAE grades. The correlation of rash grade with Skindex-16 scores ranged from r = 0.49 with the function subscale to r = 0.62 with the symptom subscale. The highest correlations of the maximum grade of any dermatological AE with the Skindex-16 were r = 0.48 for the total score and r = 0.55 for the symptom subscale.. The data reported support the decision to include both measures in a clinical trial to assess the patient experience, as each measure may specifically target varying symptoms and intensities.

Topics: Algorithms; Anti-Inflammatory Agents; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antineoplastic Agents; Breast Neoplasms; Cetuximab; Erlotinib Hydrochloride; Exanthema; Female; Gefitinib; Humans; Male; Middle Aged; Mometasone Furoate; Neoplasms; Pregnadienediols; Protein Kinase Inhibitors; Protein Synthesis Inhibitors; Quinazolines; Radiodermatitis; Randomized Controlled Trials as Topic; Severity of Illness Index; Sunscreening Agents; Surveys and Questionnaires; Terminology as Topic; Tetracycline

The Authors performed ona group a patients suffering from drug exanthema a thorough clinico-anamnestic and allergo-immunological investigation (skin reactions, patch-tests, Prausnitz-Küstner passive transport, in vitro lymphocyte blastization, total serum IgE radioimmunoassay). The results obtained do not support an immunoallergical pathogenesis of this syndrome. The possible alternative hypotheses and the future perspectives of study are discussed.

Topics: Adolescent; Adult; Aspirin; Cephalosporins; Child; Exanthema; Female; Humans; Immunization, Passive; Immunoglobulin E; Lymphocyte Activation; Male; Middle Aged; Skin Tests; Tetracycline

Rocky Mountain spotted fever continues to increase in the United States and the case-fatality ratio remains unchanged despite the availability of effective antibiotics. The apparent reason for the continuing deaths from this disease is the failure of physicians to consider the diagnosis in patients presenting with febrile exanthems in the late spring and summer months. A clinical diagnosis should be based on the history of tick exposure and the presence of fever and the typical exanthem. Serologic tests are useful mainly in retrospect. This article reviews the clinical experience with Rocky Mountain spotted fever in an endemic area in recent years and discusses problems in the diagnosis and management.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Chloramphenicol; Diagnosis, Differential; Enterovirus Infections; Exanthema; Humans; Measles; Meningococcal Infections; Middle Aged; Ohio; Rocky Mountain Spotted Fever; Seasons; Tetracycline

Topics: Adolescent; Ampicillin; Bacteria; Bacterial Infections; Child; Child, Preschool; Chloramphenicol; Cyclacillin; Drug Hypersensitivity; Exanthema; Humans; Infant; Infant, Newborn; Pediatrics; Penicillins; Private Practice; Staphylococcus; Tetracycline; Vomiting

Topics: Agranulocytosis; Anemia, Aplastic; Anti-Bacterial Agents; Bronchial Spasm; Cephalosporins; Chloramphenicol; Drug Eruptions; Exanthema; Fatty Liver; Fever; Gentamicins; Hearing Disorders; Humans; Nalidixic Acid; Nitrofurantoin; Penicillins; Sulfanilamides; Tetracycline; Urticaria

Topics: Adult; Ampicillin; Autopsy; Bradycardia; Cesarean Section; Cyanosis; Exanthema; Feces; Female; Fetal Diseases; Hepatomegaly; Humans; Infant, Newborn; Listeria monocytogenes; Listeriosis; Liver; Lung; Pregnancy; Respiration, Artificial; Respiratory Insufficiency; Serologic Tests; Tetracycline

Topics: Adult; Chemical and Drug Induced Liver Injury; Drug Interactions; Exanthema; Humans; Liver Function Tests; Male; Penicillins; Sepsis; Stevens-Johnson Syndrome; Sulfonamides; Tetracycline

Topics: Ampicillin; Anemia, Aplastic; Anti-Bacterial Agents; Bone Marrow; Chloramphenicol; Dermatitis, Contact; Drug Eruptions; Drug Hypersensitivity; Drug Tolerance; Exanthema; Humans; Immune Tolerance; Neomycin; Penicillins; Photosensitivity Disorders; Tetracycline; Tooth Discoloration

Topics: Adult; Aged; Alopecia; Anti-Bacterial Agents; Balanitis; Biopsy; Child; Child, Preschool; Chloramphenicol; Deoxyuridine; Diagnosis, Differential; Diagnostic Errors; Erythromycin; Exanthema; Female; Hemorrhoids; Hernia, Inguinal; Herpes Simplex; Humans; Lymphadenitis; Male; Metronidazole; Middle Aged; Mycoses; Oxytetracycline; Penicillins; Sarcoidosis; Sclerosis; Skin Tests; Stomatitis; Syphilis; Syphilis Serodiagnosis; Syphilis, Latent; Tetracycline

Topics: Drug Eruptions; Exanthema; Humans; Phenothiazines; Photosensitivity Disorders; Sulfonamides; Tetracycline; Ultraviolet Rays

Topics: Blood Cell Count; Blood Platelets; Exanthema; Humans; Male; Middle Aged; Rocky Mountain Spotted Fever; Tetracycline

Topics: Antimalarials; Drug Hypersensitivity; Exanthema; Humans; Phenothiazines; Photosensitivity Disorders; Sulfonamides; Tetracycline