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Abstract:
We used ciprofloxacin, a quinolone-derivative, to treat a lung infection due to Pseudomonas aeruginosa in an adult cystic fibrosis patient. On three different occasions the use of ciprofloxacin was associated with the development of an asymptomatic hematuria with red blood cell casts. The mechanism responsible for this hematuria is presently unknown, but clinicians should be aware of this potential adverse effect of ciprofloxacin.
Insights
Ciprofloxacin treatment for Pseudomonas aeruginosa lung infections in cystic fibrosis patients may cause asymptomatic hematuria. This adverse effect, characterized by red blood cells in urine, requires clinical awareness.
Area of Science:
- Nephrology
- Infectious Diseases
- Pulmonology
Background:
- Cystic fibrosis (CF) patients often experience chronic lung infections, frequently caused by Pseudomonas aeruginosa.
- Antibiotic therapy, including fluoroquinolones like ciprofloxacin, is a cornerstone in managing P. aeruginosa infections in CF.
- Quinolone derivatives are known for various potential adverse effects, necessitating ongoing safety monitoring.
Observation:
- A case study involving an adult cystic fibrosis patient treated with ciprofloxacin for a P. aeruginosa lung infection.
- The patient developed asymptomatic hematuria, confirmed by the presence of red blood cell casts in urinalysis.
- This renal adverse event recurred on three separate occasions during ciprofloxacin therapy.
Findings:
- Ciprofloxacin administration was temporally associated with the onset of asymptomatic hematuria and red blood cell casts.
- The precise mechanism underlying ciprofloxacin-induced nephrotoxicity in this context remains undetermined.
- No other potential causes for the hematuria were identified in the clinical setting.
Implications:
- Clinicians should be vigilant for potential renal adverse effects, specifically hematuria, when prescribing ciprofloxacin to cystic fibrosis patients.
- This case highlights the need for careful patient monitoring for nephrotoxicity during fluoroquinolone treatment.
- Further research into the mechanisms of quinolone-associated nephrotoxicity may inform safer antibiotic prescribing practices in vulnerable patient populations.