Anaphylactoid reaction to ciprofloxacin.
OBJECTIVE
To report a case of anaphylactoid reaction in an HIV-negative patient associated with the administration of intravenous ciprofloxacin.


METHODS
A 79-year-old Armenian man developed an anaphylactoid reaction following a first-time exposure to intravenous ciprofloxacin. This reaction was characterized by severe hypotension, wheezing, tachypnea, tachycardia, and pruritus. The patient had complete recovery once ciprofloxacin treatment was terminated and supportive care was provided.


CONCLUSIONS
Fluoroquinolones are important therapeutic agents in the management of infectious diseases and are generally safe and well tolerated. Anaphylactoid and anaphylactic reactions have been documented as adverse effects of ciprofloxacin, ofloxacin, norfloxacin, levofloxacin, and moxifloxacin. To date, >33 cases have been reported with ciprofloxacin, of which at least 10 occurred in HIV-positive patients. In Europe, 15 cases of anaphylactoid reactions to ofloxacin have been reported and, more recently, with moxifloxacin. Since anaphylactoid reactions are potentially life threatening, the administration of fluoroquinolones to patients who have experienced a prior reaction to any of these agents should be avoided, unless tolerance has been confirmed by oral challenge tests.


CONCLUSIONS
The anaphylactoid reaction in our patient was probably induced by ciprofloxacin as validated by the Naranjo probability scale. Although anaphylactoid/anaphylactic reactions are rare adverse effects of ciprofloxacin and other fluoroquinolones, clinicians should be aware of this potentially fatal event.
Ho
Dora Y
DY
Department of Medicine, Santa Clara Valley Medical Center, San Jose, CA, USA.
Song
Jessica C
JC
Wang
Clifford C
CC
D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced* / Q000503:physiopathology; D000890:Anti-Infective Agents / Q000009:adverse effects*; D002939:Ciprofloxacin / Q000009:adverse effects*; D003429:Cross Reactions; D004342:Drug Hypersensitivity / Q000503:physiopathology*; D018023:HIV Seronegativity; D006801:Humans; D008297:Male
D000890:Anti-Infective Agents; D002939:Ciprofloxacin