Acute rhabdomyolysis associated with ofloxacin/levofloxacin therapy.
OBJECTIVE
To report a case of ofloxacin/levofloxacin-induced rhabdomyolysis and to compare other reported cases from the literature.


METHODS
A 19-year-old male patient developed ofloxacin/levofloxacin-induced rhabdomyolysis during admission for periorbital cellulitis. Symptoms of myalgia, weakness, and swelling of the arms developed after 3 days of treatment with ofloxacin 800 mg/day. Laboratory analysis confirmed the presence of urine myoglobin (381.2 microg/L) and a marked increase in serum myoglobin (590.8 microg/L), along with marked elevations in serum creatine kinase (up to 16 546 IU/L).


CONCLUSIONS
In addition to ruling out other possible etiologic factors one by one, we assessed the probability of ofloxacin/levofloxacin-induced rhabdomyolysis by observing the close time relationship between drug administration and the development of symptoms/signs, as well as the close time relationship between drug withdrawal and the disappearance of symptoms/signs. An objective causality assessment by use of the Naranjo probability scale revealed that the adverse drug reaction was probable.


CONCLUSIONS
Although ofloxacin/levofloxacin-induced rhabdomyolysis appears to be rare, patients with muscle pain, swelling, or weakness during therapy should be closely monitored for this adverse effect.
Hsiao
Shu-Hwa
SH
Department of Pharmacy, National Cheng Kung University Hospital, Taiwan, Republic of China.
Chang
Chia-Ming
CM
Tsao
Chao-Jung
CJ
Lee
Yu-Yun J
YY
Hsu
May-Ying
MY
Wu
Ta-Jen
TJ
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D003402:Creatine Kinase / Q000097:blood; D006801:Humans; D064704:Levofloxacin; D008297:Male; D015242:Ofloxacin / Q000009:adverse effects*; D012206:Rhabdomyolysis / Q000139:chemically induced*
D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D015242:Ofloxacin; D003402:Creatine Kinase