Ciprofloxacin and metronidazole induced fixed drug eruption

Abstract

Fixed drug eruption(FDE) is delayed type of hypersensitivity reaction that occurs as lesions at the same skin site due to repeated intake of an offending drug.FDE can be an adverse event to different fixed dose combinations (FDC)of antiprotozoal and an antibacterial drug.A 40 years old female patient developed Blackish hyperpigmented skin lesions all over body andfluid filled skin lesions over legs and arms with itching following ingestion of Inj.Ciprofloxacin 200mg iv BD and Inj. Metronidazole 500mg iv TDS. Drug was prescribed for acute infective diarrhea and vomiting. After provisional diagnosis of Ciprofloxacin and Metronidazole induced FDE by dermatologist patient was asked to withdraw the drug immediately.The reaction was treated withInj.Pheniramine maleate 1 cc i.v. stat,Inj.Dexamethasone 1cc iv OD, Inj.Ceftriaxone 1g iv BD,Tab. levocetirizine 5mg 1OD,Tab.Betamethasone forte 1mg TDS, for local application calamine lotion, Fusidic Acid cream and Liq. Paraffin was given.Patientrecovered subsequently.It is important to report ADRs,which can help,detect and prevent drug reactions and in turn decrease the cost of treatment and adverse drug reaction causing mortality and morbidity also decreases.Concerted efforts are needed to discourage over-the-counter sales and purchase of nonprescription drugs in order to limit the occurrence of this adverse cutaneous drug eruption.