The antibiotic Avelox comes with the risk of causing severe skin side effects including Stevens Johnson Syndrome.

Also known by its generic name moxifloxacin, Avelox is classified as a fluoroquinolone antibiotic, or simply quinolone. Quinolones work by inhibiting the action of an enzyme that is necessary for replication and transcription of bacteria’s DNA.

A product of Bayer Pharmaceuticals that first got FDA approval in December 1999, Avelox is used as a treatment for several different types of bacterial infections, including complicated intra-abdominal infections, certain infections of the skin and respiratory system, and plague.

Like other quinolone antibiotics, Avelox can lead to Stevens Johnson Syndrome. One study of epidemiological data in India concluded that quinolones were one of the major causes of Stevens Johnson Syndrome and toxic epidermal necrolysis in that country from 1995 to 2011.

The current FDA-approved label for Avelox warns that certain severe dermatologic reactions, including SJS, have been reported in association with quinolones such as Avelox. Fortunately, SJS is rare, but when it does occur it’s most often caused by a drug.

SJS chiefly affects the skin, manifesting with symptoms similar to those of severe burns. The condition first presents with symptoms resembling those of the flu – symptoms like cough, fever, and body aches. Then the skin symptoms begin with areas of discoloration and rash. Within these areas blisters begin to form.

These blisters tend to grow and coalesce into large areas of skin that die and peel away. If the condition progresses to the point at which 30 percent of the body’s surface is affected, it may then be referred to as toxic epidermal necrolysis, or TEN. The two conditions are clinically similar, and there is some overlap between them.

SJS can also attack other parts of the body besides the skin. Blisters may also form on the mucous membranes of the mouth, throat, eyes or genitals. Eye symptoms can lead to inflammation, tissue damage or scarring, possibly ending in blindness. Fingernails and toenails may fall out. The loss of outer skin leads to loss of fluid and electrolytes and puts the patient at risk for skin infections and sepsis.

Treatment generally requires hospitalization, sometimes in an intensive care unit or burn unit due to the similarities to burn symptoms.

In cases of SJS caused by Avelox, the first step is to discontinue the drug as soon as possible. The patient must subsequently never use that drug again. Once the underlying cause is eliminated, treatment focuses on managing symptoms and complications while the body slowly heals itself.

Recovery may take several weeks, or even many months. Even after recovery, the skin may show permanent visible deformities, discolorations or scars. In some cases, SJS can be fatal.

It almost goes without saying that the harm caused by SJS and TEN can be enormous. The patient has to spend weeks in the hospital, racking up medical bills while at the same time being prevented from earning income. The physical pain and mental suffering involved are substantial.