Fixed drug eruptions caused by cross-reactive quinolones

Kameswari, PDeepa; Selvaraj, Nitya; Adhimoolam, Mangaiarkkarasi

doi:10.4103/0976-0105.134986

Cited by 15 publications

(5 citation statements)

References 5 publications

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“…Cross-reaction between fluoroquinolones, nitroimidazoles, fluoroquinolone-nitroimidazole combinations, and levocetirizine-cetirizine have been previously reported. [ 20 21 22 23 ] In 5 patients with FDE following an NSAID, there was a history of FDE with an analgesic/antipyretic though the exact drug was unknown. It could imply recurrence with same or a related drug.…”

Section: Discussionmentioning

confidence: 99%

Fixed-drug eruptions: What can we learn from a case series?

et al. 2018

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Background:A fixed-drug eruption (FDE) is a unique cutaneous adverse drug effect in the form of recurrent lesions at the same site after re-exposure to the offending agent.Aim:The aim of the study was to identify changes in trends in fixed drug eruptions with regard to causative drug or patient risk factors.Methods:Cases of FDEs encountered between March 2014 to May 2017 during routine pharmacovigilance activities were analyzed.Results:FDEs made up 8.4% of total adverse drug reactions and 11.1% of cutaneous reactions. Majority of the patients were adults between 18 and 45 years old. The average lag period between drug intake and appearance of FDE was 2.04 days. Commonly affected sites were extremities, lips, head and neck, and genitalia. Number of FDE lesions varied from 1 to > 6, with nearly half the patients (46%) presenting with a single lesion. Antimicrobials (80.6%) and nonsteroidal anti-inflammatory drugs (20.8%) were most frequent drugs implicated. Route of administration was oral for all causative drugs. History of an FDE was positive in 26 (50.2%) of the cases. Majority of the patients (21 out of 25 or 84%) whose lesions appeared within minutes to hours of suspected drug intake had a history of FDE. Furthermore, 66.7% of patients with multiple lesions had a history of FDE while only 34.8% of patients with a single lesion had such a history.Conclusion:FDEs are common cutaneous reactions with antimicrobials and anti-inflammatory agents, with increased likelihood of extensive and multiple lesions in patients with a history of FDE.

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Section: Discussionmentioning

confidence: 99%

Fixed-drug eruptions: What can we learn from a case series?

et al. 2018

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“…Fluoroquinolones are commonly used antimicrobials (effective for both gram negative and gram positive bacteria) in the treatment of various bacterial infections and are generally well tolerated. 15 Ofloxacin, a fluoroquinolone drug is used for the treatment of conjunctivitis and corneal ulcers and it is given quarterly in a day because its bioavailability is very low. Hence, nanoparticles of Ofloxacin were firstly prepared using EC to improve the bioavailability of drug.…”

Section: Resultsmentioning

confidence: 99%

Optimization of in-situ Nanoparticulate Gel of Ofloxacin using Factorial Design to Improve Treatment Strategy for Conjunctivitis and Corneal Ulcers

Sharma¹,

Sharma²,

Tomar³

2020

IJPER

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Background:One of the main problems in ophthalmic drug delivery is the rapid elimination of conventional liquid eye drops from the eye due to rapid tear turnover resulting precorneal loss because of irritation caused by the drug preparation from large volume of the administered eye drop (~50 µl), a very small amount i.e. <5% of the dosage actually penetrates and is able to reach intraocular tissues. Ofloxacin (OFL), a fluoroquinolone drug is used for the treatment of conjunctivitis and corneal ulcers and it is given quarterly in a day because its bioavailability is very low. The present study was designed to increase the ocular residence time of drug by formulating nanoparticulate in-situ gel for ensuring low irritation, better release and compatibility with ocular tissue. Materials and Methods: Initially, OFL nanoparticles were prepared using single emulsion solvent evaporation method and evaluated for various evaluation parameters. Based on the results, an optimized batch (B3) was selected by applying factorial design; which was further converted into in-situ gel. Results: Results of evaluation parameters revealed that optimized batch (B3) showed significant (p=0.0001 and p=0.0090) increased in particle size and entrapment efficiency in comparison to rest batches. Moreover, nanoparticulate in-situ gel showed satisfactory results. Conclusion: Hence, Ofloxacin nanoparticulate in-situ gel thus formulated showed controlled drug release with lesser dosing frequency.

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“…Cross-reactivity between NSAIDs belonging in the same group and thus chemically related has been documented in the context of FDEs, as revealed by the search of the available published literature [ 12 , 13 , 14 , 15 , 16 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. It should be noted that such reactions that are attributed to cross-reactivities between structurally related medications have been observed with the use of a variety of other agents including, but not limited to, quinolones, azoles, and antihistamines [ 4 , 42 , 43 , 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Nimesulide-Induced Fixed Drug Eruption Followed by Etoricoxib-Induced Fixed Drug Eruption: An Unusual Case Report and Review of the Literature

Makris,

Papapostolou,

Koumprentziotis

et al. 2024

JCM

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Fixed drug eruption (FDE) is a well-recognized, non-immediate, drug hypersensitivity reaction, often attributed to the use of various medications, most commonly non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics. Cross-reactivity between related NSAIDs in FDE has been reported, but among chemically unrelated NSAIDs, is rare. Herein, we present a rare well-documented case where a patient initially displayed tolerance to etoricoxib after experiencing a nimesulide-induced FDE. Subsequently, the patient developed an etoricoxib-induced FDE, accompanied by the development of bullous lesions. This case report and the literature review on comparable FDE occurrences shed light on the intricate nature of FDEs, suggesting the possibility of cross-reactivity between chemically related and unrelated NSAIDs or the emergence of new drug-specific T cells without cross-reactivity after multiple exposures to a drug in a susceptible patient. Our case underscores the importance of increased awareness and vigilance among both physicians and patients in the realm of personalized medicine. Further research is needed to unravel the intricate mechanisms behind these drug eruptions, improve diagnostic approaches, and enhance patient care.

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Fixed drug eruptions caused by cross-reactive quinolones

Cited by 15 publications

References 5 publications

Fixed-drug eruptions: What can we learn from a case series?

Fixed-drug eruptions: What can we learn from a case series?

Optimization of in-situ Nanoparticulate Gel of Ofloxacin using Factorial Design to Improve Treatment Strategy for Conjunctivitis and Corneal Ulcers

Nimesulide-Induced Fixed Drug Eruption Followed by Etoricoxib-Induced Fixed Drug Eruption: An Unusual Case Report and Review of the Literature

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