Anaphylaxis to Ciprofloxacin Requiring Emergent Surgical Cricothyrotomy

  • Wesley Tang Department of Medicine, Kettering Medical Center, Kettering, OH, USA
  • Edwina Rao Department of Medicine, Kettering Medical Center, Kettering, OH, USA


Fluoroquinolones, ciprofloxacin, emergent airway, cricothyrotomy, anaphylaxis


Although allergies to antibiotics are commonly stated, anaphylactic reactions are uncommonly reported. This is especially the case with reactions to fluoroquinolone antibiotics. Furthermore, airway emergencies are rare. We present a case of ciprofloxacin-induced acute airway obstruction and anaphylaxis, necessitating emergent surgical cricothyrotomy following respiratory distress.



  • Gruchalla RS, Pirmohamed M. Clinical practice. Antibiotic allergy. N Engl J Med 2006;354(6):601–609.
  • Bigby M, Jick S, Jick H, Arndt K. Drug-induced cutaneous reactions. A report from the Boston Collaborative Drug Surveillance Program on 15,438 consecutive inpatients, 1975 to 1982. JAMA 1986;256(24):3358–3363.
  • Bertino J, Jr., Fish D. The safety profile of the fluoroquinolones. Clin Ther 2000;22(7):798–817; discussion 797.
  • Jones SC, Budnitz DS, Sorbello A, Mehta H. US-based emergency department visits for fluoroquinolone-associated hypersensitivity reactions. Pharmacoepidemiol Drug Saf 2013;22(10):1099–1106.
  • Demir S, Gelincik A, Akdeniz N, Aktas-Cetin E, Olgac M, Unal D, et al. Usefulness of in vivo and in vitro diagnostic tests in the diagnosis of hypersensitivity reactions to quinolones and in the evaluation of cross-reactivity: a comprehensive study including the latest quinolone gemifloxacin. Allergy Asthma Immunol Res 2017;9(4):347–359.
  • Brockow K, Garvey LH, Aberer W, Atanaskovic-Markovic M, Barbaud A, Bilo MB, et al. Skin test concentrations for systemically administered drugs - an ENDA/EAACI Drug Allergy Interest Group position paper. Allergy 2013;68(6):702–712.
  • Seitz CS, Bröcker EB, Trautmann A. Diagnostic testing in suspected fluoroquinolone hypersensitivity. Clin Exp Allergy 2009;39(11):1738–1745.
  • Lobera T, Audícana MT, Alarcón E, Longo N, Navarro B, Muñoz D. Allergy to quinolones: low cross-reactivity to levofloxacin. J Investig Allergol Clin Immunol 2010;20(7):607–611.
  • Ben Said B, Berard F, Bienvenu J, Nicolas JF, Rozieres A. Usefulness of basophil activation tests for the diagnosis of IgE-mediated allergy to quinolones. Allergy 2010;65(4):535–536.
  • Doña I, Moreno E, Pérez-Sánchez N, Andreu I, Hernández Fernandez de Rojas D, Torres MJ. Update on quinolone allergy. Curr Allergy Asthma Rep 2017;17(8):56.
  • Doña I, Blanca-López N, Torres MJ, García-Campos J, García-Núñez I, Gómez F, et al. Drug hypersensitivity reactions: response patterns, drug involved, and temporal variations in a large series of patients. J Investig Allergol Clin Immunol 2012;22(5):363–371.
  • Bratsman A, Mathias K, Laubscher R, Grigoryan L, Rose S. Outpatient fluoroquinolone prescribing patterns before and after US FDA boxed warning. Pharmacoepidemiol Drug Saf 2020;29(6):701–707.
  • Published: 2022-02-24

    Issue: 2022: Vol 9 No 2 (view)

    Section: Articles

    How to cite:
    Tang W, Rao E. Anaphylaxis to Ciprofloxacin Requiring Emergent Surgical Cricothyrotomy. EJCRIM 2022;9 doi:10.12890/2022_003180.