%0 Journal Article
%T Biopsy proven acute interstitial nephritis after treatment with moxifloxacin
%A Christos Chatzikyrkou
%A Iyas Hamwi
%A Christian Clajus
%A Jan Becker
%A Carsten Hafer
%A Jan T Kielstein
%J BMC Nephrology
%D 2010
%I BioMed Central
%R 10.1186/1471-2369-11-19
%X Here we describe a case of biopsy proven interstitial nephritis after moxifloxacin treatment. The patient presented with fever, rigors and dialysis dependent acute kidney injury, just a few days after treatment of a respiratory tract infection with moxifloxacin. The renal biopsy revealed dense infiltrates mainly composed of eosinophils and severe interstitial edema. A course of oral prednisolone (1 mg/kg/day) was commenced and rapidly tapered to zero within three weeks. The renal function improved, and the patient was discharged with a creatinine of 107 ¦Ìmol/l.This case illustrates that pharmacovigilance is important to early detect rare side effects, such as AIN, even in drugs with a favourable risk/benefit ratio such as moxifloxacin.Acute interstitial nephritis (AIN) is an important cause of reversible acute kidney injury [1]. It is demonstrated in 2-3% of all native renal biopsies, increasing to 10-15% in the setting of acute kidney injury [2]. The etiology of at least two thirds of all cases is thought to be drug-induced [3]. Although methicillin and other ¦Â-lactam antibiotics are the prototype offending agents for many years and are causative in about a third of all drug induced AIN, numerous other medications have been incriminated. Despite the enormous clinical and marketing success fluoroquinolones have enjoyed over the past 20 years, this group has only rarely been linked to AIN. There are about 30 case reports that the most widely used group II fluoroquinolones (ciprofloxacin and ofloxacin) which exhibit mainly activity against Gram-negative bacteria can cause AIN [4]. Recently group III (levofloxacin) and group IV fluoroquinolones (moxifloxacin), which show an improved activity against Gram-positive pathogens while maintaining similar activity against many Gram-negative bacteria, have been increasingly used [5]. Although there are some reports that levofloxacin can induce AIN [6] there has been only a report linking moxifloxacin to biopsy proven AIN [7].W
%U http://www.biomedcentral.com/1471-2369/11/19