Cutaneous adverse reactions to fluoroquinolones.

Background: To date, even though there are some large studies on adverse reactions related to fluoroquinolones, there is no comprehensive study focusing on cutaneous adverse drug reactions associated with their use.

Objective: To demonstrate the pattern of cutaneous reaction related to the administration of each type of fluoroquinolone and to study the cross-sensitivity between various types of fluoroquinolones.

Methods: Voluntary reports of any adverse events associated with fluoroquinolone use as reported from January 2004 to December 2008 and obtained from the Adverse Drug Reaction Center, Siriraj Hospital, Thailand, were reviewed.

Results: Among 166,736 patients who had been treated with fluoroquinolones, the prevalences of adverse reaction and cutaneous adverse reaction were 0.13% and 0.09%, respectively. The prevalence of cutaneous reaction to individual fluoroquinolones varies between 0.04% and 0.37%. One hundred fifty-one subjects were enrolled. Most cutaneous reactions were attributed to ciprofloxacin (n = 93), and the most frequent adverse cutaneous reaction seen was maculopapular rash (39.7%). Thirteen cases (8.6%) involved a previous history of fluoroquinolone hypersensitivity; among these, 15.4% had cross-reactivity potential.

Conclusion: These data suggest that individual fluoroquinolones are responsible for different types and frequencies of cutaneous reactions, with some potentiality of cross-reactivity between different generations.