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Chulalongkorn Medical Journal

Abstract

Ofloxacin, a second-generation fluoroquinolone, is a relatively rare but documented cause of fixed drug eruption (FDE), a localized cutaneous hypersensitivity reaction marked by recurrent, well-demarcated erythematous patches or macules that may develop into blisters upon re-exposure to the offending agent. The underlying mechanism is immune-mediated, involving T-cell activation, cytokine release, and keratinocyte apoptosis. A 5-year-old boy weighing 15 kg was prescribed Ofloxacin syrup (7.5 ml twice daily) and Paracetamol suspension (5 ml twice daily) for suspected enteric fever. Within two days, he developed several annular erythematous lesions on his hands and back, associated with intense itching, raising suspicion of a drug-induced hypersensitivity reaction. As both medications are potential triggers, a thorough clinical evaluation including detailed history and, if necessary, patch testing was considered essential to identify the offending agent. Immediate discontinuation of the suspected drug was initiated, and an alternative antibiotic was selected to manage the infection without exacerbating the skin reaction. Management involved symptomatic relief using topical corticosteroids and antihistamines. This case highlights the importance of early recognition and careful evaluation of adverse cutaneous drug reactions in children. Prompt identification and documentation of such events play a crucial role in ensuring patient safety, guiding future therapy, and strengthening pharmacovigilance practices.

DOI

10.56808/2673-060X.5592

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