AN ANTIBIOTIC DRUG-INDUCED ALLERGIC REACTION IN A PATIENT WITH MULTIPLE COMORBIDITIES. CLINICAL CASE

Abstract

Drug induced allergic reactions due to antibiotics rarely occur. Penicillin is the antibiotic class that is mostly commonly associated with drug induced allergic reactions (10 %). They are followed by quinolones (2 %) which will be discussed in this case based review. Fluoroquinolones allergic reactions can either present as an immediate reaction which requires urgent medical attention or a delayed reaction. Among the antibiotics of this class, moxifloxacin has been reported as the drug which is likely to result in occurrence of an allergic reaction. Some of the dermatologic eruptions that could manifest include maculopapular exanthema, urticarial, Steven Johnson Syndrome, fixed drug eruptions and drug rash with eosinophilia and systemic symptoms (DRESS). The diagnosis needs a thorough history and physical examination, skin test, in vitro testing and drug provocation tests. Management includes discontinuation of the provoking agent and administration of antihistamines or corticosteroids depending on the situation. The case of the 75 year old lady who had an allergic reaction following administrations of ciprofloxacin and follow up management plan is described in the article. The case illustrates and urgent necessity of quaternary prevention in primary care to avoid harming patients while choosing the best and safe therapy.