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 CASE REPORT
Year : 2002  |  Volume : 34  |  Issue : 5  |  Page : 283-285

Dapsone induced methemoglobinemia, sulfhemoglobinemia and hemolytic anemia: A case report with a note on treatment strategies



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R Prasad


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The development of fluoroquinolones in early 1980s was a breakthrough in the treatment of infectious diseases. The basic structure of fluoroquinolone consists of quinolone carboxylic acid. The modifications at various positions in structure have resulted in a series of potent compounds having wide spectrum of activity which includes gram negative and gram positive organisms, mycobacterium, chlamydia etc. They act by selective inhibition of bacterial DNA gyrase enzyme. These compounds have proved their utility in the treatment of various infections viz., U.T.I, acute bacterial diarrhoea1 diseases, gonorrhoea, chanchroid, S.typhi infection and various other systemic infections. They also have good prophylactic role in surgery and in immunocompromised patients. Compared to other antimicrobial agents, resistance to fluoroquinolones is not common and in addition, they have fewer and mild side effects like g.i.t disturbances (most frequent), mild CNS reactions (headache, dizziness, sleepiness) and hypersensitivity reactions. The bioavailability of fluoroquinolones is decreased with concomitant administration of antacids, iron salts, ranitidine and pirenzipine. Some of the fluoroquinolones (ciprofloxacin, enoxacin) significantly raise the plasma levels of theophylline and caffeine. Although a large number of fluoroquinolones have been developed in the recent past, yet there is need for compounds which have broader spectrum of activity, higher potency, better CNS/CSF penetration and better patient tolerability.






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