Acute Pancreatitis Secondary to Ciprofloxacin Therapy in Patients with Infectious Colitis
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Background/Aims: Ciprofloxacin is considered to be a safeand effective treatment for acute infectious colitis. However,this drug may cause drug-induced pancreatitis, albeit rarely. Methods: From March 2007 to February 2012, we studied227 patients who were hospitalized for infectious colitis atSt. Mary’s Hospital. All of the patients received ciprofloxacintherapy for the treatment of infectious colitis. We observed afew cases of rare adverse events, including ciprofloxacin-inducedacute pancreatitis diagnosed based on the Naranjo algorithm. Results: During ciprofloxacin therapy, seven of 227patients (3.1%) developed rare pancreatitis as defined bythe Naranjo algorithm; pancreatic enzyme activity was sporadicallyelevated with ciprofloxacin use. After ciprofloxacinadministration, the average interval until the development ofpancreatitis was 5.5 days (range, 4 to 7 days). On abdominalcomputed tomography, pancreatic swelling and homogenousenhancement was noted in three of seven patients. Complicatingacute pancreatitis was gradually but completelyresolved after cessation of ciprofloxacin administration. Themean recovery time was 11.3 days (range, 8 to 15 days). Conclusions: We observed that ciprofloxacin-induced pancreatitismay occur with an incidence of approximately 3%. Ciprofloxacin-induced pancreatitis presents a short latency,suggesting an idiosyncratic hypersensitivity reaction. Practitionersshould be aware that drug-induced pancreatitis canoccur during ciprofloxacin therapy.
Abstract
Background/Aims: Ciprofloxacin is considered to be a safeand effective treatment for acute infectious colitis. However,this drug may cause drug-induced pancreatitis, albeit rarely. Methods: From March 2007 to February 2012, we studied227 patients who were hospitalized for infectious colitis atSt. Mary’s Hospital. All of the patients received ciprofloxacintherapy for the treatment of infectious colitis. We observed afew cases of rare adverse events, including ciprofloxacin-inducedacute pancreatitis diagnosed based on the Naranjo algorithm. Results: During ciprofloxacin therapy, seven of 227patients (3.1%) developed rare pancreatitis as defined bythe Naranjo algorithm; pancreatic enzyme activity was sporadicallyelevated with ciprofloxacin use. After ciprofloxacinadministration, the average interval until the development ofpancreatitis was 5.5 days (range, 4 to 7 days). On abdominalcomputed tomography, pancreatic swelling and homogenousenhancement was noted in three of seven patients. Complicatingacute pancreatitis was gradually but completelyresolved after cessation of ciprofloxacin administration. Themean recovery time was 11.3 days (range, 8 to 15 days). Conclusions: We observed that ciprofloxacin-induced pancreatitismay occur with an incidence of approximately 3%. Ciprofloxacin-induced pancreatitis presents a short latency,suggesting an idiosyncratic hypersensitivity reaction. Practitionersshould be aware that drug-induced pancreatitis canoccur during ciprofloxacin therapy.
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