title: Acute rhabdomyolysis associated with ofloxacin/levofloxacin therapy.
abstract: 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.
authors.affiliation: Department of Pharmacy, National Cheng Kung University Hospital, Taiwan, Republic of China.
authors.forename: Shu-Hwa
authors.initials: SH
authors.lastname: Hsiao
authors.forename: Chia-Ming
authors.initials: CM
authors.lastname: Chang
authors.forename: Chao-Jung
authors.initials: CJ
authors.lastname: Tsao
authors.forename: Yu-Yun J
authors.initials: YY
authors.lastname: Lee
authors.forename: May-Ying
authors.initials: MY
authors.lastname: Hsu
authors.forename: Ta-Jen
authors.initials: TJ
authors.lastname: Wu
mesh_terms: 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*
chemical_list: D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D015242:Ofloxacin; D003402:Creatine Kinase