Cross immediate hypersensitivity between ciprofloxacin and levofloxacin: a case report and literature review

Chotirat Nakaranurack

Abstract


Fluoroquinolones can show cross-reactivity because of the similar chemical structure. Levofloxacin is a new fluoroquinolone and can be a safe alternative due to low cross-reactivity. This is a case report showing cross-reactivity between ciprofloxacin and levofloxacin. A 64-year-old man was diagnosed as cellulitis and Pseudomonas bloodstream infection. Ciprofloxacin was given intravenously then after infusion for a few minutes, patient felt pain around the injection area, following by burning sensation along the course of his superficial vein. He had also diffuse skin flushing, dizziness, blurred vision, pruritus and urticaria on the waist. Piperacillin/tazobactam was administered instead of ciprofloxacin. Before hospital discharge, he received oral levofloxacin. Within 1 hour after starting levofloxacin oral, he had swollen upper lip and numbness on the right side of the face. In conclusion, Health care providers will be aware when prescribing levofloxacin to patients who have hypersensitivity reaction to ciprofloxacin.

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