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Ciprofloxacin-induced renal dysfunction in patients with mycobacterial lung infections
Abstract:
3 patients with mycobacterial lung infections, one due to Mycobacterium avium-intracellulare and 2 due to M. tuberculosis, developed ciprofloxacin-induced acute renal dysfunction while receiving the drug together with other antimycobacterial agents. These episodes took place 8-10 days after commencement of therapy and recovered spontaneously after cessation of all antimycobacterial drugs for 2-8 weeks. No recurrence was noted when patients were restarted on regimens that did not contain ciprofloxacin.
Insights
Ciprofloxacin can cause acute kidney injury in patients with mycobacterial lung infections. Discontinuation of ciprofloxacin led to spontaneous recovery of renal function, with no recurrence upon re-challenge with alternative regimens.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Mycobacterial lung infections require prolonged antimicrobial therapy.
- Fluoroquinolones, including ciprofloxacin, are used in treating certain mycobacterial infections.
- Drug-induced renal dysfunction is a potential complication of antimicrobial therapy.
Observation:
- Three patients with mycobacterial lung infections (one Mycobacterium avium-intracellulare, two Mycobacterium tuberculosis) developed acute renal dysfunction.
- The renal dysfunction emerged 8-10 days after initiating ciprofloxacin alongside other antimycobacterial agents.
- Renal function improved spontaneously within 2-8 weeks after discontinuing all antimycobacterial drugs.
Findings:
- Ciprofloxacin, in combination with other antimycobacterial drugs, was associated with acute kidney injury in these patients.
- Cessation of ciprofloxacin was linked to the recovery of renal function.
- No relapse of renal dysfunction occurred when patients were treated with regimens excluding ciprofloxacin.
Implications:
- Clinicians should monitor renal function in patients receiving ciprofloxacin for mycobacterial infections.
- Ciprofloxacin should be considered a potential cause of acute renal dysfunction in this patient population.
- Avoiding ciprofloxacin may be crucial for patients with a history of ciprofloxacin-induced nephrotoxicity during mycobacterial treatment.