Discussion
Cefoperazone/sulbactam-induced SJS/TEN is mostly an idiosyncratic, dose
independent, unpredictable adverse event (4) . But there are
important factors such as the individual variation in drug metabolism or
clearance, HIV-1 seropositivity, polypharmacy and competitive drug
inhibition may also play role in cefoperazone/sulbactam induced SJS/TEN(5) . The mortality risk of patients in TEN is around 40%. High
dose IVIG therapy given in early SJS and TEN has been beneficial to
arrest disease progression and reduce mortality, although not f. Doses
at ≥2 g/kg were associated with less mortality. IVIG treatment should be
initiated early after the diagnosis. The use of corticosteroids and
immunosuppressive agents simultaneous to IVIG therapy is controversial.
The dose of IVIG in TEN is advised to be a total of ≥3 g/kg divided into
3–5 days at a time. Long term treatment is not recommended(6) .