Comparative analysis of cutaneous drug reactions among different fluoroquinolones: an experimental study

Background: Fluoroquinolones are generally well tolerated; most adverse effects are mild and common are GI upset. But recent literatures suggest increase reports of Cutaneous Drug reactions (CDRs) including SJS with Fluoroquinolones. However there is insufficient data both in animal and clinical study regarding comparative Analysis of CDRs among different Fluoroquinolones. Hence the present study was under taken to evaluate incidence of comparative CDRs among different Fluoroquinolones.Methods: 96 Albino mice were divided into 16 groups of 6 each. Ciprofloxacin, Ofloxacin, Levofloxacin and Moxifloxacin were administered in Group 1-4, 5-8, 9-12 and 13-16 at the dose of 50/100/150/200mg/kg respectively. The following parameters were observed i.e. Number and % of mice developed CDRs with type and severity. Duration of exposure till development of CDRs, time to Recovery and Mortality in each group.Results: Ofloxacin produced maximum number of CDRs i.e. in 33.3% mice which was significantly higher than that with levofloxacin (p=0.006*). The incidence of CDRs with Ciprofloxacin was 16.67 % and Moxifloxacin16.67 %, but no statistically significant difference than Ofloxacin. The onset for CDRs was significantly earlier with Ofloxacin among the Fluoroquinolones (P=0.013*). The reactions varied from severe dermatitis to serious exfoliation of the skin with ofloxacin and Ciprofloxacin, Alopecia with Moxifloxacin but no cutaneous reactions to Levofloxacin. Mortality was found only with Ofloxacin (12.5%).Conclusions: CDRs are common and may present as severe skin exfoliation or Alopecia with Fluoroquinolones. The CDRs are Maximum with Ofloxacin without significant difference from ciprofloxacin but significantly higher than levofloxacin which has least potential for CDRs. Fatality may occur with Ofloxacin.