Can quinolones cause hemorrhagic colitis of late onset? Report of three cases.
OBJECTIVE
This study was undertaken to demonstrate that quinolones may cause acute colitis resembling penicillin-induced hemorrhagic colitis.


METHODS
We reviewed the medical records of patients with acute colitis in our institutes. Twenty-eight patients with acute hemorrhagic colitis in which no pathogenic microorganisms were identified were the subjects of this study. Pseudomembranous colitis caused by Clostridium difficile was excluded. Ulcerative colitis, Crohn's disease, and radiation proctocolitis were also excluded.


RESULTS
Among these patients, 25 had a history of recent administration of penicillin derivatives. The remaining three patients had never been given any penicillin derivatives, but had ingested quinolones approximately four weeks before the developing colitis had been identified. Klebsiella oxytoca was also isolated in these three patients.


CONCLUSIONS
Quinolones may cause acute hemorrhagic colitis. The time interval from antibiotic ingestion to onset of the condition may be much longer in quinolones than in penicillin derivatives.
Koga
H
H
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Japan.
Aoyagi
K
K
Yoshimura
R
R
Kimura
Y
Y
Iida
M
M
Fujishima
M
M
D000208:Acute Disease; D000328:Adult; D000890:Anti-Infective Agents / Q000009:adverse effects*; D001424:Bacterial Infections / Q000188:drug therapy; D003092:Colitis / Q000139:chemically induced* / Q000473:pathology; D003113:Colonoscopy; D015365:Enoxacin / Q000009:adverse effects; D005260:Female; D024841:Fluoroquinolones; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009287:Naphthyridines / Q000009:adverse effects; D015242:Ofloxacin / Q000009:adverse effects
D000890:Anti-Infective Agents; D024841:Fluoroquinolones; D009287:Naphthyridines; D015365:Enoxacin; D015242:Ofloxacin; C055185:tosufloxacin