Pharmaceutical care for one case of levofloxacin-induced hypersensitivity reaction by the participation of clinical pharmacists and literature analysis
|更新时间:2025-09-23
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Pharmaceutical care for one case of levofloxacin-induced hypersensitivity reaction by the participation of clinical pharmacists and literature analysis
YIN Huanli,HUANG Yuezhou,LUO Min,et al.Pharmaceutical care for one case of levofloxacin-induced hypersensitivity reaction by the participation of clinical pharmacists and literature analysis[J].ZHONGGUO YAOFANG,2023,34(22):2805-2809.
YIN Huanli,HUANG Yuezhou,LUO Min,et al.Pharmaceutical care for one case of levofloxacin-induced hypersensitivity reaction by the participation of clinical pharmacists and literature analysis[J].ZHONGGUO YAOFANG,2023,34(22):2805-2809. DOI: 10.6039/j.issn.1001-0408.2023.22.21.
Pharmaceutical care for one case of levofloxacin-induced hypersensitivity reaction by the participation of clinical pharmacists and literature analysis
To analyze the characteristics of levofloxacin-induced hypersensitivity reaction.
METHODS
2
Clinical pharmacists participated in the treatment for a case of levofloxacin-induced hypersensitivity reaction, and adjudged the relationship of levofloxacin with hypersensitivity reaction according to relative standards. Retrieved from CNKI, VIP, Wanfang database, PubMed and Embase, relevant literature about levofloxacin-induced hypersensitivity reaction was collected and analyzed.
RESULTS
2
Clinical pharmacists suggested checking the patient’s previous medication and allergy history based on symptoms such as fever and systemic rash, and determined that the drug hypersensitivity was “likely” or “highly likely” to be associated with levofloxacin. Clinicians provided symptomatic treatment to the patient based on the judgment of clinical pharmacists, and the patient improved after treatment. Results of the literature analysis showed that among 31 involved patients, there were 23 males and 8 females; 18 patients aged 50 and above; the incubation period of 24 patients was within 4 days after medication. The main adverse drug reactions were drug hypersensitivity syndrome, fixed drug eruption, erythema multiforme, etc. Most patients were improved after withdrawal and symptomatic treatment.
CONCLUSIONS
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Hypersensitivity reaction is the rare adverse drug reaction of levofloxacin, mostly occurring within 2.5 h to 4 days after administration, and it is more likely to occur in middle-aged and elderly patients. Before clinical use, patients should be asked about their drug allergy history in detail; when patients experience fever or rash without obvious causes, medication should be stopped promptly and symptomatic treatment should be taken to ensure the safety and effectiveness of the patients’ medication.
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references
LIU R , HU S L , ZHANG Y J , et al . Mast cell-mediated hypersensitivity to fluoroquinolone is MRGPRX2 dependent [J ] . Int Immunopharmacol , 2019 , 70 : 417 - 427 .
Allergic Diseases Professional Committee of Dermato-logists Branch of the Chinese Medical Association . Expert consensus on diagnosis and treatment of drug hypersen-sitivity syndrome [J ] . Chin J Dermatol , 2018 , 51 ( 11 ): 787 - 790 .
SHIOHARA T , MIZUKAWA Y . Drug-induced hypersensitivity syndrome(DiHS)/drug reaction with eosinophilia and systemic symptoms(DRESS):an update in 2019 [J ] . Allergol Int , 2019 , 68 ( 3 ): 301 - 308 .
KARDAUN S H , SIDOROFF A , VALEYRIE-ALLANORE L , et al . Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms:does a DRESS syndrome really exist? [J ] . Br J Dermatol , 2007 , 156 ( 3 ): 609 - 611 .
NARANJO C A , BUSTO U , SELLERS E M , et al . A method for estimating the probability of adverse drug re-actions [J ] . Clin Pharmacol Ther , 1981 , 30 ( 2 ): 239 - 245 .
MATSUMOTO T , HORINO T , INOTANI S , et al . Drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome(DRESS/DIHS)caused by levofloxacin in a patient with systemic scleroderma,rheumatoid arthritis,and Sjogren syndrome [J ] . Contact Dermatitis , 2019 , 80 ( 4 ): 253 - 254 .
KILLEBREW S , GONZALEZ-ESTRADA A . Quinolone hypersensitivity reaction:a difference between generations;please mind the gap [J ] . Ann Allergy Asthma Immunol , 2018 , 121 ( 5 ): S64 .
GAJJAR K , HIRAPARA H , JAISWAL C S , et al . A case report of antitubercular drugs induced exanthematous re-action complicated by acute onset levofloxacin induced toxic epidermal necrolysis(TEN) [J ] . Curr Drug Saf , 2018 , 13 ( 1 ): 41 - 43 .
KATSUBE O , ANZAI M , NOMURA Y , et al . A case of drug-induced hypersensitivity syndrome caused by levofloxacin used for treating pulmonary tuberculosis [J ] . Tuberculosis , 2014 , 89 ( 2 ): 51 - 56 .
DENG Y H , ZHENG X X , SONG Y . Drug hypersensi-tivity syndrome caused by levofloxacin:a case report [J ] . Chin J Hosp Pharm , 2013 , 33 ( 15 ): 1299 - 1300 .
WANG P , ZHU L K , HE Y J , et al . A case of fixed drug eruption caused by levofloxacin lactate tablets [J ] . Chin J Dermatovenereology , 2021 , 35 ( 3 ): 355 - 356 .
ZHANG H H , MOU Y . Fixed drug eruption due to levofloxacin lactate and sodium chloride injection [J ] . Adverse Drug React J , 2020 , 22 ( 12 ): 717 - 718 .
CHEN M L , DENG J L , HUO Y D , et al . A case of bullous epidermolysis drug eruption caused by levofloxacin treated by combination of traditional Chinese and western medicine [J ] . J Sichuan Tradit Chin Med , 2010 , 28 ( 5 ): 110 .
XU L J , LI X X . One suspected case of toxic epidermal necrolysis induced by levofloxacin [J ] . Chin J Drug Appl Monit , 2015 , 12 ( 4 ): 258 - 260 .
BIAN H L . Bullous epidermolysis type drug eruption and renal damage induced by levofloxacin [J ] . Adverse Drug React J , 2010 , 12 ( 5 ): 362 - 363 .
MA C F , SUN Y Y . A case of severe fixed drug eruption caused by levofloxacin injection [J ] . Chin J Pharmacoepidemiol , 2010 , 19 ( 7 ): 419 .
BEN FREDJ N , AOUAM K , CHAABANE A , et al . Fixed drug eruption:levofloxacin,another culprit drug [J ] . J Clin Pharmacol , 2012 , 52 ( 5 ): 775 - 777 .
FERNÁNDEZ ARENAS O , LÓPEZ LUNAR E , GUTIÉRREZ GARCÍA M , et al . Levofloxacin-related stevens-Johnson syndrome [J ] . Farm Hosp , 2012 , 36 ( 1 ): 53 - 55 .
CHARFI O , LAKHOUA G , SAHNOUN R , et al . DRESS syndrome following levofloxacin exposure with positive patch-test [J ] . Therapie , 2015 , 70 ( 6 ): 547 - 549 .
LEE J H , LEE W Y , YONG S J , et al . A case of levofloxa-cin-induced anaphylaxis with elevated serum tryptase levels [J ] . Allergy Asthma Immunol Res , 2013 , 5 ( 2 ): 113 - 115 .
KATO Y , SATO Y , NAKASU M , et al . Immediate type hypersensitivity and late phase reaction occurred consecutively in a patient receiving ethambutol and levofloxacin [J ] . Allergy Asthma Clin Immunol , 2018 , 14 : 13 .
SHARMA A , BALDI A , SHARMA D K . Levofloxacin induced bullous fixed drug eruption:a rare case report [J ] . Eur J Hosp Pharm , 2022 , 29 ( e1 ): e95 - e96 .
MIZUTA T , KASAMI S , SHIGEHARA Y , et al . Urushiol-induced airborne and systemic pustular dermatitis from Japanese lacquer [J ] . Contact Dermatitis , 2022 , 86 ( 1 ): 62 - 64 .
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