Pulmonary Toxicity with Fluoroquinolones

Adverse drug reactions associated with antimicrobials have become a topic of major importance and concern in the last few years. Fluroquinolones are a group of interesting and at times unpredictable class of antimicrobial agents which are used extensively in clinical practice. Over the past 20 years, fluoroquinolones have demonstrated landmark safety profiles. Ciprofloxacin and levofloxacin remain two of the safest and best-tolerated fluroquinolones over a wide range of doses. The most common drug-related adverse effects with fluoroquinolone therapy involve the gastrointestinal tract and central nervous system (1). Others include skin rashes, pruritis, photoallergic reactions, arthropathy, and tendinopathy, especially in patients younger than 30 years old. These adverse effects are usually transient and mild to moderate in severity, and rarely require discontinuation of therapy. However, serious toxic reactions have also been reported. We report two cases of hypersensitive pneumonitis with vasculitis followed exposure to ciprofloxacin and/or levofloxacin.