A CASE PRESENTATION ON OFLOXACIN INDUCED DERMAL HYPERSENSITIVITY REACTION
DOI:
https://doi.org/10.22159/ijpps.2022v14i3.43640Keywords:
Hypersensitivity reaction [HSR], Ofloxacin, Injection site reaction, Adverse drug reaction [ADR]Abstract
Ofloxacin is a second-generation fluoroquinolone and is highly effective against a wide range of bacterial infections. Fluoroquinolones are well-tolerated drugs with mild-to-moderate adverse effects such as gastrointestinal disturbances, skin reactions, and neurological reactions. These are widely used antimicrobials, which can cause cutaneous ADRs in about 1%–2% of patients. Hypersensitivity reactions due to ofloxacin are found rarely, ranging in frequency from 0.4% to 2%, respectively. This case report highlights one such event of cutaneous ADR by the use of ofloxacin injection causing Injection site reaction after a few minutes of Ofloxacin infusion. Based on history and clinical examination patient was diagnosed as ofloxacin induced hypersensitivity reaction and was successfully treated with antihistamines and corticosteroids. General management of ADR includes withdrawal/suspension, dose reduction of the suspected drug, and administration of supportive therapy. In this case, the suspected drugs were withdrawn and the patient was treated symptomatically. Pharmacovigilance should be a part of patient care to reduce the occurrence of adverse drug reactions and also encourage practitioners in reporting to gather more and more data regarding adverse drug reactions.
Due to the rarity of Ofloxacin induced ADRs this article sheds light on one of such cases to help in pharmacovigilance
Downloads
References
Todd PA, Faulds D. Ofloxacin a reappraisal of its antimicrobial activity, pharmacology and therapeutic use. Drugs. 1991 Nov;42(5):825-76. doi: 10.2165/00003495-199142050-00008, PMID 1723377.
Method development and validation of simultaneous determination of ofloxacin and satranidazole in pharmaceutical dosage form by RP-HPLC | Abstract [internet]. Vol. 9480. Available from: https://www.scholarsresearchlibrary.com/ abstract/method-development-and-validation-of-simultaneous-determination-of-ofloxacin-and-satranidazole-in-pharmaceutical-dosage.html. [Last accessed on 13 Oct 2021]
Kumar A, Tiwari BK, Kumar S. Evaluation of ocular films of ofloxacin for antibacterial activity. Int J App Pharm. 2018 Nov 7;10(6):275-89. doi: 10.22159/ijap.2018v10i6.27188.
Shahwal V, Kumar DBK, Bhoumick M. Preformulation study of levofloxacin. Int J Adv Pharm. 2012;1(1):1-8.
Neki NS. Hypersensitivity reaction to ofloxacin: a case report. J Chitwan Med Coll. 2015;5(4):75-7. doi: 10.3126/jcmc.v5i4.16558.
Hosaka H, Ohtoshi S, Nakada T, Iijima M. Erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis: frozen-section diagnosis. J Dermatol. 2010 May;37(5):407-12. doi: 10.1111/j.1346-8138.2009.00746.x, PMID 20536645.
Worm M, Hanschmann Mohn T, Scherer Hofmeier K, Cardona V, Turner P, Dolle-Bierke S. Drug-induced anaphylaxis-elicitors, mechanisms and diagnosis. Allergo J Int. 2019 Dec 1;28(8):327-9. doi: 10.1007/s40629-019-00109-2.
Ofloxacin Induced Hypersensitivity Reaction | Chetna Desai-Academia. Available from: https://www.academia.edu/ 50356051/Ofloxacin_Induced_Hypersensitivity_Reaction. [Last accessed on 13 Oct 2021].
Azimi E, Reddy VB, Lerner EA. Brief communication: MRGPRX2, atopic dermatitis and red man syndrome. Itch Phila Pa. 2017 Mar;2(1):e5.
Sawada M, Nakamura S, Yamada A, Kobayashi T, Okada S. Phase IV study and post-marketing surveillance of ofloxacin in Japan. Chemotherapy. 1991;37(2):134-42. doi: 10.1159/000238845, PMID 2032469.
Blanca Lopez N, Andreu I, Torres Jaen MJ. Hypersensitivity reactions to quinolones. Curr Opin Allergy Clin Immunol. 2011 Aug;11(4):285-91. doi: 10.1097/ACI.0b013e3283489bc3, PMID 21659860.
Jungst G, Mohr R. Side effects of ofloxacin in clinical trials and in postmarketing surveillance. Drugs. 1987 Oct 1;34(1) Suppl 1:144-9. doi: 10.2165/00003495-198700341-00031, PMID 3325257.
Lohsiriwat V. Treatment of hemorrhoids: A coloproctologist’s view. World J Gastroenterol. 2015 Aug 21;21(31):9245-52. doi: 10.3748/wjg.v21.i31.9245, PMID 26309351.
McNeil BD, Pundir P, Meeker S, Han L, Undem BJ, Kulka M, Dong X. Identification of a mast-cell-specific receptor crucial for pseudo-allergic drug reactions. Nature. 2015 Mar 12;519(7542):237-41. doi: 10.1038/nature14022, PMID 25517090.
Kim JH, Seo DH, Ban GY, Yang EM, Shin YS, Ye YM, Park HS. An ofloxacin-induced anaphylaxis through an IgG4-mediated but not IgE-mediated basophil activation mechanism. Korean J Crit Care Med. 2017 Aug 1;32(3):302-5. doi: 10.4266/kjccm.2017.00108, PMID 31723651.
Porebski G, Kwiecien K, Pawica M, Kwitniewski M. Mas-related g protein-coupled receptor-X2 (MRGPRX2) in drug hypersensitivity reactions. Front Immunol. 2018;9:3027. doi: 10.3389/fimmu.2018.03027, PMID 30619367.
Aranda A, Mayorga C, Ariza A, Doña I, Rosado A, Blanca Lopez N, Andreu I, Torres MJ. In vitro evaluation of IgE-mediated hypersensitivity reactions to quinolones. Allergy. 2011 Feb;66(2):247-54. doi: 10.1111/j.1398-9995.2010.02460.x, PMID 20722637.
Lembo PMC, Grazzini E, Groblewski T, O’Donnell D, Roy MO, Zhang J, Hoffert C, Cao J, Schmidt R, Pelletier M, Labarre M, Gosselin M, Fortin Y, Banville D, Shen SH, Ström P, Payza K, Dray A, Walker P, Ahmad S. Proenkephalin A gene products activate a new family of sensory neuron-specific GPCRs. Nat Neurosci. 2002 Mar;5(3):201-9. doi: 10.1038/nn815, PMID 11850634.
Liu R, Hu S, Zhang Y, Che D, Cao J, Wang J, Zhao T, Jia Q, Wang N, Zhang T. Mast cell-mediated hypersensitivity to fluoroquinolone is MRGPRX2 dependent. Int Immunopharmacol. 2019 May 1;70:417-27. doi: 10.1016/j.intimp.2019.02.001, PMID 30856392.
Dong X, Han S, Zylka MJ, Simon MI, Anderson DJ. A diverse family of GPCRs expressed in specific subsets of nociceptive sensory neurons. Cell. 2001 Sep 7;106(5):619-32. doi: 10.1016/s0092-8674(01)00483-4, PMID 11551509.
Roy S, Ganguly A, Haque M, Ali H. Angiogenic host defense peptide AG-30/5C and Bradykinin B2 receptor antagonist Icatibant are G protein-biased agonists for MRGPRX2 in mast cells. J Immunol Baltim Md 1950. 2019 Feb 15;202(4):1229-38.
Published
How to Cite
Issue
Section
Copyright (c) 2022 Divya Bhavanam, Ledo Thankachan
This work is licensed under a Creative Commons Attribution 4.0 International License.
