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March 2003, Vol 93, No. 3 | American Journal of Public Health 489-492
© 2003 American Public Health Association

RESEARCH AND PRACTICE

Outbreak of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Associated With Mebendazole and Metronidazole Use Among Filipino Laborers in Taiwan

Kow-Tong Chen, MD, PhD, Shiing-Jer Twu, MD, PhD, Hong-Jen Chang, MD, MSc and Ruey-Shiung Lin, MD, DrPH

Kow-Tong Chen is with the Field Epidemiology Training Program, Center for Disease Control, Department of Health, Taiwan, Republic of China. Shiing-Jer Twu is with the Center for Disease Control, Department of Health, Taiwan. Hong-Jen Chang is with the Department of Health, Taiwan. Ruey-Shiung Lin is with the Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan.

Correspondence: Requests for reprints should be sent to Ruey-Shiung Lin, MD, DrPH, Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan No. 19, Hsuchow Rd, Taipei, Taiwan, Republic of China (e-mail: ktchen{at}cdc.gov.tw).

Objectives. This study sought to identify the risk factors associated with an outbreak of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) among Filipino laborers in Taiwan.

Methods. Forty-six SJS/TEN patients were matched to 92 controls according to month of arrival in Taiwan, sex, and age.

Results. The odds ratio for development of SJS/TEN was 9.5 (95% confidence interval [CI] = 3.9, 23.9) among workers who had used both metronidazole and mebendazole sometime in the preceding 6 weeks. In addition, a gradient increase in the occurrence of SJS/TEN was found with an increasing level of exposure to metronidazole.

Conclusions. This outbreak highlights the risk of SJS/TEN resulting from the use of both metronidazole and mebendazole and the need for control measures.




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Mycoplasma Pneumoniae Infection and Stevens-Johnson Syndrome / Toxic Epidermal Necrolysis
Ta-Chen Su
AJPH Online, 17 Feb 2004 [Full text]

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