Cipro is a powerful antibiotic medication that is associated with rare but life-threatening cases of Stevens-Johnson Syndrome (SJS), a skin reaction that causes the top layer of skin to peel off.
Cipro and Stevens-Johnson Syndrome (SJS)
Cipro is the brand-name for ciprofloxacin, a powerful antibiotic that has been on the market in the U.S. since 1987 and is sold by Bayer.
SJS has been reported in patients who used Cipro, according to the Cipro Prescribing Information (PDF). Patients should immediately stop using Cipro and seek medical attention at the first sign of a skin rash or allergic reaction. Hypersensitivity reactions can occur after a single dose of Cipro.
Case Reports Linking SJS and Cipro
One of the most serious case report linking SJS and Cipro was published in 1993. The 31 year-old woman developed a rash after her first dose of Cipro, but continued taking it.
By the time she went to the hospital 6 days later, the rash covered her entire body and she had to be treated in the burn unit. She was diagnosed with the most severe form of SJS — Toxic Epidermal Necrolysis (TEN).
Another set of case reports was published in 2003 by researchers in Sweden. They described two patients who developed SJS after taking Cipro. They also reviewed 8 more reports in Sweden from 1988-2000.
What is SJS?
Stevens-Johnson Syndrome (SJS) is a rare but serious skin reaction. It can also involve mucous membranes in the eyes, nose, mouth, throat, genitals, and intestines. Most cases are caused by medications.
What is the Risk?
Over 100 medications are known to cause SJS, but the risk is very low. Only two or three people out of every 1 million people in the U.S. and Europe develop SJS per year. Most cases are not deadly.
Toxic Epidermal Necrolysis (TEN)
The most severe form of SJS is Toxic Epidermal Necrolysis (TEN). It involves a rash on at least 30% of the skin and has a 20-30% risk of death. In comparison, SJS involves less than 10% of the skin. SJS and TEN are sometimes diagnosed as erythema multiforme or Lyell’s syndrome.
Warning Signs & Symptoms
- Nausea, vomiting
- General ill feeling
- Itchy skin
- Achy joints and muscles
- Rash that spreads
- Skin lesions or sores
Symptoms of SJS
One dose of Cipro is all it takes to cause SJS. It starts with a flu-like illness and a rash anywhere on the body. The rash spreads quickly and is raised, painful, red or purplish, and accompanied by blisters. The top layer of skin (epidermis) dies and peels off in large sheets.
Complications of SJS
Large sections of damaged skin and open sores are susceptible to infection. SJS sometimes spreads to the eyes, resulting in vision loss or blindness. It can also cause permanent disfigurement to the skin. When deaths occur, they are usually caused by bloodstream infections (sepsis), organ failure, or severe inflammation in the lungs.