Patients who notice a Cipro rash after starting a course of antibiotics may be experiencing the first signs of a more serious and potentially deadly skin reaction.

Cipro, or ciprofloxacin, is widely used for many varying types of bacterial infections, including infections of the respiratory and urinary tracts, skin and bone infections, and gastrointestinal infections.

It’s one of a class of antibiotics called fluoroquinolones, which work by interfering with bacteria’s DNA in a way that inhibits cell division.

Cipro rash is one of the known side effects associated with this drug. While a drug rash may be innocuous and resolve on its own, Cipro rash could also be an early sign of a much more serious and life-threatening skin condition like Stevens Johnson Syndrome.

For that reason, the warning label for Cipro advises that Cipro should be discontinued immediately at the first appearance of a drug rash on the skin.

Stevens Johnson Syndrome Reaction

SJS exists on the relatively milder end of a spectrum of drug-induced skin conditions. At the spectrum’s other end is toxic epidermal necrolysis, a related condition with much more severe and widespread symptoms.

SJS typically first manifests with fever, itching, and inflammation of the pharynx and the tissues surrounding the eyes. The more characteristic symptoms of SJS appear later; these include areas of rash, blisters, and detachment of the outer layer of skin in an area covering less than 10 percent of the body.

Both Stevens Johnson Syndrome and toxic epidermal necrolysis are among the many possible adverse reactions associated with Cipro. A Cipro rash can be one of the first signs of either of these conditions.

When the condition is caused by a drug like Cipro, the first step is to withdraw that medication right away. After that, treatment for SJS depends on the severity.

Milder cases of SJS may respond well to topical steroids. More severe cases may require more involved treatment – the patient may need some combination of fluid replacement, nutritional support, antibacterial therapy, and treatment of eye symptoms by an ophthalmologist.

Cipro Rash Case Study

One case study published in the Journal of Young Pharmacists in January 2016 tells the story of a 43-year-old man who was diagnosed with Stevens Johnson Syndrome. The man sought medical help after suffering from an apparent drug rash and from painful and purulent lesions inside his mouth and on his genitals and both hands.

The patient also reported fever, salivation, and conjunctivitis in his eyes. His recent medical history had included a course of ciprofloxacin for an upper respiratory tract infection. Algorithmic analysis indicated a probable relationship between the man’s course of Cipro and his later development of Stevens Johnson Syndrome.

Doctors diagnosed the man with Stevens Johnson Syndrome and admitted him to the hospital. Following treatment with dexamethasone and prednisone, his condition gradually improved. He was discharged after nine days of hospitalization. After four more weeks of treatment with prednisone, his lesions had resolved.

For this patient, things could have been much worse. SJS can put a patient at risk for life-threatening systemic infections, shock or organ failure due to the loss of the outer layer of skin. Eye damage and scarring can leave the patient blind. Even when the lost skin grows back, it can be distorted with scars, bumps and discoloration.