Acute pancreatitis secondary to ciprofloxacin therapy in patients with infectious colitis.
OBJECTIVE
Ciprofloxacin is considered to be a safe and effective treatment for acute infectious colitis. However, this drug may cause drug-induced pancreatitis, albeit rarely.


METHODS
From March 2007 to February 2012, we studied 227 patients who were hospitalized for infectious colitis at St. Mary's Hospital. All of the patients received ciprofloxacin therapy for the treatment of infectious colitis. We observed a few cases of rare adverse events, including ciprofloxacin-induced acute pancreatitis diagnosed based on the Naranjo algorithm.


RESULTS
During ciprofloxacin therapy, seven of 227 patients (3.1%) developed rare pancreatitis as defined by the Naranjo algorithm; pancreatic enzyme activity was sporadically elevated with ciprofloxacin use. After ciprofloxacin administration, the average interval until the development of pancreatitis was 5.5 days (range, 4 to 7 days). On abdominal computed tomography, pancreatic swelling and homogenous enhancement was noted in three of seven patients. Complicating acute pancreatitis was gradually but completely resolved after cessation of ciprofloxacin administration. The mean recovery time was 11.3 days (range, 8 to 15 days).


CONCLUSIONS
We observed that ciprofloxacin-induced pancreatitis may occur with an incidence of approximately 3%. Ciprofloxacin-induced pancreatitis presents a short latency, suggesting an idiosyncratic hypersensitivity reaction. Practitioners should be aware that drug-induced pancreatitis can occur during ciprofloxacin therapy.
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Hye Young
HY
Sung
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Jin Il
JI
Kim
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Hyun Jeong
HJ
Lee
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Hyung Jun
HJ
Cho
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Dae Young
DY
Cheung
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Sung Soo
SS
Kim
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Se Hyun
SH
Cho
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Jae Kwang
JK
Kim
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001424:Bacterial Infections / Q000188:drug therapy*; D002939:Ciprofloxacin / Q000009:adverse effects*; D003092:Colitis / Q000188:drug therapy*; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D004952:Esters; D005260:Female; D016670:Gabexate / Q000031:analogs & derivatives / Q000627:therapeutic use; D006146:Guanidines; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000139:chemically induced* / Q000188:drug therapy; D055815:Young Adult
D000900:Anti-Bacterial Agents; D004791:Enzyme Inhibitors; D004952:Esters; D006146:Guanidines; C034532:camostat; D016670:Gabexate; D002939:Ciprofloxacin
Anti-bacterial agents; Drug toxicity; Infectious colitis; Pancreatitis