盐酸左氧氟沙星注射液致Stevens-Johnson综合征  

Stevens-Johnson syndrome caused by levofloxacin hydrochloride injection

作　　者：李建伟 杨蕊[2] Li Jianwei;Yang Rui(Department of Clinical Pharmacy,Shouguang Hospital of Traditional Chinese Medicine,Shandong Province,Shouguang 262700,China;Department of Clinical Pharmacy,the First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan Hospital,Shandong Engineering and Technology Research Center for Pediatric Drug Development,Shandong Medicine and Health Key Laboratory of Clinical Pharmacy,Jinan 250014,China)

机构地区：[1]山东省寿光市中医医院临床药学室,寿光262700 [2]山东第一医科大学第一附属医院(山东省千佛山医院)临床药学部,山东省儿童药物临床评价与研发工程技术研究中心,山东省医药卫生临床药学重点实验室,济南250014

出　　处：《药物不良反应杂志》2023年第3期187-189,共3页Adverse Drug Reactions Journal

摘　　要：1例32岁男性患者因社区获得性肺炎给予盐酸左氧氟沙星注射液0.6 g静脉滴注、1次/d。首次用药约30 min后, 患者双手掌及双足底出现水疱样红色皮疹。考虑与盐酸左氧氟沙星注射液有关, 停用该药, 给予地塞米松磷酸钠注射液5 mg静脉滴注。第2天, 患者体温39.8 ℃, 皮疹及瘙痒症状加重, 面部、胸背部、四肢出现散在红斑状皮疹, 口腔、眼部、外阴部黏膜出现糜烂及溃疡, 诊断为Stevens-Johnson综合征。给予甲泼尼龙、葡萄糖酸钙、更昔洛韦、亚胺培南西司他丁钠、泮托拉唑等抗炎抗过敏治疗, 并予黏膜修复、营养支持、皮肤护理等对症支持治疗。7 d后患者体温恢复正常;9 d后躯干部多处水疱样红色皮疹颜色变淡、塌陷;24 d后, 患者双手、足底可见新生皮肤, 胸背部皮疹消退, 口腔、外阴黏膜愈合良好。A 32-year-old male patient with community-acquired pneumonia received levofloxacin hydrochloride injection 0.6 g by intravenous infusion once daily.About 30 minutes after the first medication,the patient developed blister-like red rash on the palms of both hands and pelma of both feet.Considering that it was related to levofloxacin hydrochloride injection,the drug was discontinued and an IV infusion of dexamethasone sodium phosphate injection 5 mg was given.On the second day,the patient′s body temperature was 39.8℃,the rash and itching symptoms were aggravated,scattered erythematous rash appeared on his face,chest and back,both upper and lower limbs,and erosion and ulcer appeared on the mucous membranes of the mouth,eyes and vulva.The patient was diagnosed as having Stevens-Johnson syndrome.Anti-inflammatory and anti-allergic treatments such as methylprednisolone,calcium gluconate,ganciclovir,imipenem and cilastatin sodium,pantoprazole,as well as symptomatic and supportive treatments such as mucosal repair,nutritional support,skin care,etc.were given.Seven days later,the patient′s temperature returned to normal;7 days later,many blister-like red skin rashes on the trunk became pale and collapsed;24 days later,new skin could be seen on the hands and feet of the patient,the erythematous rash on the chest and back was subsided,and the mucosa of the mouth and vulva was well healed.

关 键 词：喹诺酮类 STEVENS-JOHNSON综合征 皮疹 左氧氟沙星 

分 类 号：R969[医药卫生—药理学]