International Journal of Basic & Clinical Pharmacology | March 2020 | Vol 9 | Issue 3 Page 510 International Journal of Basic & Clinical Pharmacology Narasimha GL et al. Int J Basic Clin Pharmacol. 2020 Mar;9(3):510-512 http://www.ijbcp.com pISSN 2319-2003 | eISSN 2279-0780 Case Report Amoxicillin induced toxic epidermal necrolysis Lakshmi Narasimha G.*, Kalpana P. INTRODUCTION Amoxicillin is a broad spectrum, bactericidal and a beta lactam antibiotic that is used in treatment of various infections. The most important concern regarding the use of antibiotics is the occurrence of adverse drug reactions. These reactions appear in the form of drug eruptions on the skin as maculopapular rashes, urticarial eruptions, serum sickness like reactions (SSLR), blisters formation and bullous erythema etc. Toxic epidermal necrolysis (TEN) is the serious life-threatening drug eruption associated with the use of amoxicillin. 1 It is characterised by epidermal sloughing, blisters and mucocutaneous reactions. Drug and its metabolites are the main cause for the development of TEN. The following drugs were reported with TEN like sulphonamides, allopurinol, carbamazepine, phenobarbital, nevirapine, penicillin and non-steroidal anti- inflammatory drugs (NSAIDs) etc. 2 CASE REPORT A 22 years old male was admitted in the Government General Hospital, Kadapa with complaints of Sloughing of skin, small blisters on the trunk and four limbs with presence of burning sensation all over the body (Figure 1 and 2). He was diagnosed with fever for last three days and received tablet amoxicillin-clavulanic acid and injection amoxicillin sodium as initial drug treatment with the dose of 625 mg and 250 mg twice daily respectively. Complaints developed after administering of those drugs for fever within three days. During his admission, after clear examination it was found that the lesions are erythematous macular lesions with darker haemorrhagic pattern all over the body and dislodgment of epidermis on the limb region. No mucosal and genital involvement. Nikolsky’s sign was positive. The condition was diagnosed as drug induced TEN and the suspecting drug was amoxicillin as causative by the dermatologist. Except the skin lesions rest of the findings were normal. Laboratory investigation were Hb- 10.5 gm%, TC- 1200 Department of Pharmacy Practice, Annamacharya College of Pharmacy, Rajampeta, Kadapa, Andhra Pradesh, India Received: 02 January 2020 Accepted: 11 February 2020 *Correspondence: Dr. Lakshmi Narasimha G., Email: gunturunarasimha007@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Toxic epidermal necrolysis (TEN) is a rare life-threatening adverse drug reaction associated with mucocutaneous eruptions and peeling of skin (sloughing) mostly caused by drugs like sulphonamides, beta lactams, carbamazepine and non-steroidal anti-inflammatory drugs (NSAIDs). Amoxicillin is a broad spectrum, bactericidal, Beta-lactam antibiotic used in treatment of various infections. Here by we have reported the case of amoxicillin induced severe toxic epidermal necrolysis. A Patient admitted in the hospital with the symptoms of epidermal sloughing that resulted in bare dermis as he received Amoxicillin drug for his diagnosis of fever. After clear examination TEN was confirmed and suspected with the cause due to Amoxicillin. The drug was stopped and patient was treated with other drugs for symptomatic cure. The patient was recovered from his condition and improved significantly. Keywords: Amoxicillin, Adverse drug reactions, Life threatening, Mucocutaneous eruptions, Skin sloughing, Toxic epidermal necrolysis DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20200731