Rifaximin-Induced Adverse Drug Reaction of Toxic Epidermal Necrolysis (TEN) in a Patient of Chronic Liver Failure: A Case Report

Authors : Dr. Prasenjit Sarkar; Dr. N. Meena Devi

Volume/Issue : Volume 8 - 2023, Issue 7 - July

Google Scholar : https://bit.ly/3TmGbDi

Scribd : https://tinyurl.com/2xf36ec3

DOI : https://doi.org/10.5281/zenodo.8233364

Introduction: Rifaximin is a semi-synthetic antibiotic used to treat hepatic encephalopathy, traveller’s diarrhoea, and irritable bowel syndrome. Common adverse effects of Rifaximin are headache, dizziness, tiredness, GIT manifestations etc. Toxic epidermal necrolysis (TEN), is a very rare adverse effect of rifaximin therapy. Case Description: A 49 years old alcoholic male with chronic liver disease started on tablet rifaximin 400 mg twice daily in a tertiary health care hospital. After 12 days of taking the medicine, he developed multiple fluid-filled bullous lesions over the lips, chest, abdomen, back, extremities, and genitalia, suggestive of TEN. In routine investigations TLC, Total and direct bilirubin, liver enzymes were high and PT, INR were deranged.  Results: TEN was managed by inj. Dexamethasone and inj. Azithromycin and topical ointment. Tab. Rifaximin was withdrawn. His condition improved on review after a week. Conclusion: TEN is a rare but serious adverse effect of rifaximin therapy. Our observation adds to the literature of drug- induced TEN and its successful control by drug withdrawal and corticosteroid therapy.

Keywords : Rifaximin, Toxic Epidermal Necrolysis, Chronic Liver Disease, Corticosteroid, Azithromycin.


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