Farid S, et al. - This trial entailed the elucidation of clinical presentation, diagnosis, and outcomes of patients with biopsy-proven acute interstitial nephritis (AIN) related to fluoroquinolone (FQ) therapy. The results disclosed that the onset of FQ-related AIN could be delayed, and a high index of suspicion was warranted by physicians evaluating these patients. Favorable overall outcomes were reported. In addition, recovery to baseline renal function ensued within 3 weeks of discontinuing the offending drug.

Methods

• A retrospective review was carried out of the biopsy-proven AIN attributed to FQ use at Mayo Clinic's campus in Rochester, Minnesota, from January 1, 1993, through December 31, 2016.
• A renal pathologist reviewed the cases and these cases were attributed to FQ use by an expert nephrologist.
• In addition, the authors appraised and summarized all published case reports of biopsy-proven AIN that were attributed to FQ use.

Results

• A total of 24 patients with FQ-related biopsy-proven AIN were selected.
• Ciprofloxacin was the most commonly prescribed FQ in 17 patients (71%), and the median antibiotic treatment duration was 7 days (interquartile range [IQR], 5-12 days).
• It was reported that the median time from the initiation of FQ to the diagnosis of AIN was 8.5 days (IQR, 3.75-20.75 days). Fever (12; 50%), skin rash (5; 21%), and flank pain (2; 8%) were discovered to the common clinical manifestations.
• Nine patients (38%) presented with peripheral eosinophilia.
• Nonetheless, 4 (17%) patients appeared to be asymptomatic at the time of diagnosis and AIN was suspected on the basis of routine laboratory monitoring.
• Following the discontinuation of antibiotic therapy, maximum patients (17; 71%) underwent recovery.
• The renal function returned to baseline at a median of 20.5 days (IQR, 11.75-27.25 days).
• It was determined that 6 patients (25%) required temporary hemodialysis, and 14 patients (58%) received corticosteroid therapy.