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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
Summary
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.
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