Which drug category is most commonly implicated in inducing Stevens-Johnson syndrome?

• A. Antibiotics
• B. Sulfa
• C. NSAIDs
• D. Anticonvulsants

Answer: (B)

Stevens-Johnson syndrome is a severe, immune-mediated reaction to a drug that causes extensive damage to the skin and mucous membranes. The drug category most commonly linked to this reaction is sulfonamide antibiotics. These drugs are classic triggers because their metabolites can form haptens that strongly activate cytotoxic T cells, leading to widespread epidermal cell death and the characteristic detachment of skin and mucous membranes. Although other drug groups, like anticonvulsants and NSAIDs, can also cause SJS, sulfonamide antibiotics have the strongest and most consistent association in reported cases, which is why they’re considered the most common culprits.