Abstract

Last month the US Food and Drug Administration required American manufacturers of long-acting sulphonamides (sulphamethoxypyridazine, Lederkyn - Lederle and Midicel - PD; sulphadimethoxine - Madribon - Roche) to warn prescribers that in rare cases the Stevens-Johnson syndrome may develop as a severe and sometimes fatal side effect. This syndrome is a type of erythema multiforme in which large blisters appear on the skin and especially on the mucous membranes. The manufacturers were also to advise doctors ‘to consider prescribing short-acting sulphonamides first because they are effective for most of the same conditions’. The three drug firms concerned accordingly sent a joint warning letter to all doctors, pointing out that the Stevens-Johnson syndrome is a serious complication with a mortality rate of about 25%. So far 116 cases of this syndrome have been reported in association with the use of long-acting sulphonamides, most of them in the United States. Almost two thirds of the patients were children.