Related Experiment Video

Updated: Aug 5, 2026

High Throughput, Real-time, Dual-readout Testing of Intracellular Antimicrobial Activity and Eukaryotic Cell Cytotoxicity
09:09

High Throughput, Real-time, Dual-readout Testing of Intracellular Antimicrobial Activity and Eukaryotic Cell Cytotoxicity

Published on: November 16, 2016

Levofloxacin-induced fixed drug eruption

Shruti Vihang Brahmbhatt1, Malay Jayantigiri Goswami2, Mahavir Singh Rajput3

  • 1Pharmacology, SBKS Medical Institute and Research Centre, Waghodia, Gujarat, India.

BMJ Case Reports
|July 28, 2026
PubMed

Insights

Fixed drug eruption is a skin reaction that recurs in the same spot after taking a specific drug. This case shows levofloxacin, an antibiotic, can cause this reaction, emphasizing careful drug history and reporting.

Area of Science:

  • Dermatology
  • Pharmacology
  • Internal Medicine

Background:

  • Fixed drug eruption (FDE) is a specific type of cutaneous adverse drug reaction.
  • Antimicrobials are frequent triggers, but fluoroquinolones are less commonly implicated in FDE.
  • Recurrence at the same site upon re-exposure and post-inflammatory hyperpigmentation are characteristic features of FDE.

Purpose of the Study:

  • To report a case of fixed drug eruption.
  • To highlight levofloxacin as a potential trigger for FDE.
  • To emphasize the importance of recognizing FDE and accurate adverse drug reaction reporting.

Main Methods:

  • A case study of a male patient in his 30s.
  • Clinical diagnosis based on lesion characteristics and temporal relationship with drug intake.
  • Causality assessment using the Naranjo scale.

Main Results:

  • The patient developed FDE after receiving levofloxacin for a lower respiratory tract infection.
  • Lesions appeared on the upper lip, upper limbs, and foot within 24 hours.
  • Withdrawal of levofloxacin led to lesion resolution and post-inflammatory hyperpigmentation.

Conclusions:

  • Levofloxacin can cause fixed drug eruption.
  • Recognition of FDE triggered by common antibiotics is crucial.
  • Thorough drug history and adverse drug reaction reporting are essential for patient safety.
Keywords:
Pharmacology and therapeuticsUnwanted effects / adverse reactions

Related Concept Videos

Drug Toxicity: Allergic Reactions01:30

Drug Toxicity: Allergic Reactions

Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial exposure to a...
Drug toxicity: Idiosyncratic Reactions01:16

Drug toxicity: Idiosyncratic Reactions

Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...
Allergic Drug Reactions01:27

Allergic Drug Reactions

Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing numerous...
Dosage Regimen: Fixed Dose01:01

Dosage Regimen: Fixed Dose

Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
Drug Toxicity: Dose-Dependent Reactions01:24

Drug Toxicity: Dose-Dependent Reactions

Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...