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Acute generalized exanthematous pustulosis (AGEP) is acute onset of non-follicular, sterile pustules on an erythematous base. AGEP is commonly caused by drugs. A 65-year- woman, who suffered from systemic sclerosis, received 2 weeks of ertapenem and de-escalated to trimethoprim-sulfamethoxazole with good clinical outcome and no adverse reaction. During admission, this patient developed pneumonia and imipenem was initiated while trimethoprim-sulfamethoxazole was discontinued. This patient developed AGEP after 8 days of imipenem therapy and skin eruptions disappeared after imipenem administration finally ceased. This is a case of AGEP due to imipenem and no cross reaction to ertapenem. Nonetheless, re-challenge of other antipseudomonal carbapenems may be used cautiously.
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