Cipro Linked to the Serious Allergic Reaction Stevens-Johnson Syndrome

The fluoroquinolone antibiotic Cipro (ciprofloxacin) is one the medications linked to the extreme allergic reaction Stevens-Johnson syndrome (SJS).

Though Stevens-Johnson is not common, it can be fatal if not treated quickly, according to Top Class Actions.

Cipro is a drug in the fluoroquinolone family; fluoroquinolones are among the most widely prescribed drugs in the United States. Avelox (moxifloxacin) and Levaquin (levofloxacin) are two other popular fluoroquinolones. These drugs are effective in treating a range of serious infections, including urinary tract and gastrointestinal infections, but fluoroquinolones are also associated with reports of serious side effects, including Stevens-Johnson.

The Stevens-Johnson risk is a serious concern for prescribing physicians because there is no diagnostic tool to determine if a patient is likely to develop SJS. Researchers have not determined why certain patients develop SJS or why certain medications seem to trigger the reaction.

The Mayo Clinic describes Stevens-Johnson as “a rare, serious disorder” of the skin and mucous membranes. SJS is usually a reaction to a medication or an infection, and it often begins with “flu-like symptoms, followed by a painful red or purplish rash that spreads and blisters.” Blisters form within the areas of rash, and the outer layer of skin peels away. The throat can swell up, making it difficult for the patient to breathe and swallow. When the affected skin sheds, it exposes underlying tissue to possible infection.

The Mayo Clinic describes Stevens-Johnson as a “medical emergency.” Treatment usually requires hospitalization, often in a hospital burn unit, because burn units have the expertise in treating extensive skin damage. Some patients need skin grafts to replace areas of lost skin. Stevens Johnson syndrome can also damage the eyes, causing scar tissue inside the eyelids, scratching of the cornea, and possibly permanent blindness.

If the underlying cause of Stevens-Johnson syndrome can be eliminated and the skin reaction is halted, new skin may soon begin to grow over the affected area. In severe cases, full recovery may take months, and the patient may be left with permanent scars and disfigurement.

Fluoroquinolones are also associated with side effects involving the central nervous system, muscles, tendons and joints, according to Law360. Side effects can arise quickly— sometimes within hours of the first dose of the fluoroquinolone—or side effects can develop weeks after exposure. Levaquin (levofloxacin), in particular, has been linked to tendon damage, especially to ruptures of the Achilles tendon. This class of drugs is associated with aortic aneurysm or aortic dissection, conditions that can be fatal is the aorta ruptures.

In May 2016, the Food and Drug Administration (FDA) issued a fluoroquinolone warning addressing fluoroquinolone injuries and side effects. In weighing the adverse event reports, the FDA concluded that the risk of serious side effects generally outweighs the benefits of fluoroquinolones for treating less-serious conditions such as chronic bronchitis, earaches, sinusitis, and uncomplicated urinary tract infections. The FDA recommends that doctors reserve fluoroquinolones for more serious infections like anthrax, plague and pneumonia, according to Law360. For milder infections, fluoroquinolones should be used only when there is no other treatment alternative.