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Anaphylactoid reaction to ciprofloxacin
Dora Y Ho1, Jessica C Song, Clifford C Wang
1Department of Medicine, Santa Clara Valley Medical Center, San Jose, CA, USA.
The Annals of Pharmacotherapy
|July 5, 2003
Summary
A rare anaphylactoid reaction occurred in an HIV-negative patient after intravenous ciprofloxacin. This fluoroquinolone adverse effect, though uncommon, can be life-threatening, necessitating caution in patients with prior reactions.
Area of Science:
- Pharmacology
- Clinical Medicine
- Adverse Drug Reactions
Background:
- Fluoroquinolones, including ciprofloxacin, are widely used antibiotics for various infections.
- While generally safe, rare but severe adverse reactions like anaphylaxis can occur.
- Previous reports have documented anaphylactoid reactions to ciprofloxacin, some in HIV-positive individuals.
Observation:
- A 79-year-old male experienced a severe anaphylactoid reaction upon first-time exposure to intravenous ciprofloxacin.
- Symptoms included significant hypotension, respiratory distress (wheezing, tachypnea), tachycardia, and pruritus.
- The patient recovered fully after discontinuing ciprofloxacin and receiving supportive care.
Findings:
- The Naranjo probability scale indicated a probable link between ciprofloxacin and the observed anaphylactoid reaction.
- This case highlights a potentially fatal adverse effect of ciprofloxacin, even in HIV-negative patients.
- Anaphylactoid and anaphylactic reactions are known, albeit rare, side effects of fluoroquinolones like ciprofloxacin, ofloxacin, and levofloxacin.
Implications:
- Clinicians must be vigilant for anaphylactoid reactions when prescribing ciprofloxacin and other fluoroquinolones.
- Patients with a history of fluoroquinolone-induced reactions should avoid re-exposure unless desensitization is confirmed.
- Awareness of these rare but severe adverse events is crucial for patient safety in infectious disease management.