Prevention Starts with Awareness: Reducing the Risk of Severe Drug Reactions

Every October, Canadian Patient Safety Week reminds us of the importance of preventing harm before it happens. For rare but serious conditions like Stevens–Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), prevention means reducing risk for everyone: by improving drug safety, recognizing early signs, and responding quickly when reactions occur. While we cannot always predict who will develop them, greater awareness can help reduce the risk.

Understanding the Risk

SJS and TEN are very serious reactions to certain medications. They mostly cause blistering and peeling of the skin and the lining inside our mouths or eyes. Drugs like antibiotics and medicines for seizures are commonly associated with causing SJS/TEN. Although lots of people use these drugs safely, only a few will develop SJS/TEN. Because it's so rare, finding out who is at risk can be tough, so systems that watch for medication problems ("pharmacovigilance") are very important.

How We Learn Which Drugs Are Risky

For over 50 years, doctors have reported drug reactions to large databases like the FDA Adverse Event Reporting System (MedWatch). This helps us learn which medicines carry the most risk for SJS/TEN. Collecting this information guides safer prescribing choices for doctors, pharmacists, and nurses and helps patients everywhere.

Why Risks Vary: Genetic traits and Medication Choices

The risk of SJS/TEN isn’t the same for everyone. Genetic traits, such as certain HLA genes, make some people more likely to develop SJS/TEN after taking particular medications. This makes it important for healthcare providers to consider genetics whenever possible when prescribing medicines and ensure such testing is done before using medications known to cause SJS/TEN.

Recent studies have found that some antibiotics are among the most frequent causes of SJS/TEN. That's why doctors and pharmacists must use antibiotics carefully and look out for early symptoms of SJS/TEN. Learning these patterns helps improve drug safety for everyone.

Pharmacists: The Medication Experts

Pharmacists play a key role in keeping patients safe from severe drug reactions. They can help figure out which drug might have caused the problem and work with your doctor to choose a safer alternative. If SJS/TEN or any drug reaction is suspected, pharmacists can review your medicines to avoid further harm and recommend options that are less likely to trigger another reaction.

Working Together for Better Prevention

Preventing serious drug reactions takes teamwork: doctors, pharmacists, patients, and regulators support each other. New programs focus on catching early warning signs and acting quickly. The biggest way to prevent problems is through education, clear communication, and making sure everyone knows the risk factors.

Spotting Early Symptoms Saves Lives

Early symptoms like fever, sore throat, red or irritated eyes, show up days before any blistering or peeling starts. If these appear, stopping the medication and seeking medical help immediately is crucial. Educating patients, wearing MedicAlert bracelets for drug allergies and specifically for SJS/TEN being the reaction, can help ensure you won't be given the same medication again.

When Reactions Happen: Multidisciplinary Care

Sometimes, severe reactions can’t be avoided. Getting care from a team of specialists, such as skin doctors (dermatologists), eye doctors, burn care, and mental health professionals, leads to the best results. Reporting drug reactions to regulators like FDA or Health Canada afterwards helps improve medicine safety for future patients.

Conclusion

Preventing SJS/TEN starts with awareness among healthcare professionals, patients, and caregivers alike. Recognizing early symptoms, reporting suspected drug reactions, and improving communication between providers and patients can make all the difference. By continuing to strengthen pharmacovigilance and collaboration across healthcare systems, we can move closer to a world where severe drug reactions are identified faster and managed more safely.

This October, during Canadian Patient Safety Week, let us remember that awareness saves lives and that prevention starts with all of us.

References

1. Castellana E, Budau PM, Chiappetta MR. Pharmacovigilance and Stevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN): 55 Years of Retrospective Analysis of the FDA Adverse Event Reporting System (FAERS) Database. Hospital Pharmacy. 2025 Apr 30:00185787251337610.

   
   

2. Phillips EJ. Defining Regional Differences in Drug-Induced SJS/TEN: A Tool to Improve Drug Safety? Clin Pharmacol Ther. 2017;102(4):589-591. https://doi.org/10.1002/cpt.1175

   
   

3. Yan X, Ma J, Guo C, Yang G. Association of antibiotics with Stevens-Johnson syndrome and toxic epidermal necrolysis: a real-world pharmacovigilance study. International Journal of Antimicrobial Agents. 2025 Apr 25:107524.

   
   

4. Marks ME, Botta RK, Abe R, Beachkofsky TM, Boothman I, Carleton BC, Chung WH, Cibotti RR, Dodiuk-Gad RP, Grimstein C, Hasegawa A. Updates in SJS/TEN: collaboration, innovation, and community. Frontiers in Medicine. 2023 Oct 11;10:1213889.

   
   

5. Shanbhag SS, Chodosh J, Fathy C, et al. Multidisciplinary Care in Stevens-Johnson Syndrome. Ther Adv Chronic Dis. 2020;11:2040622319894469.

   
   

6. U.S. Food and Drug Administration. MedWatch: The FDA Safety Information and Adverse Event Reporting Program [Internet]. Silver Spring (MD): FDA; [cited 2025 Oct 9]. Available from: https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program