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Abstract
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Dear Editor:
Kakes et al recently highlighted a case
where pancreatitis was suspected to be caused
by doxycycline.1 We appreciate the authors
for highlighting this uncommon case and rais-
ing awareness about drug safety worldwide.
Additionally, we have included some key points
related to this circumstance.
The case report indicates that cephalexin
was initiated to treat a surgical site infection and
was taken for 4 days at a dosage of 500 mg 3
times daily. The patient was switched to a dif-
ferent antibiotic due to stomach discomfort.
It is important to note that the initial adverse
reaction experienced by the patient – stomach
upset – could be attributed to gastritis or early
signs of pancreatic injury. For example, a case
reported by Alim et al mentions acute pancre-
atitis due to cephalexin in a 55-year-old female
who took 500 mg of cephalexin preventively.
She presented to the emergency department
(ED) 3 hours later with sudden upper abdomen
pain radiating to her back. Her lipase levels
were 889 units/liter on initial tests.2 Afterward,
she received doxycycline treatment for 10 days.
Throughout the antibiotic regimen, ibuprofen
800 mg was taken intermittently for 7 days.
Additionally, aside from the author’s cita-
tions, several other cases provide strong evi-
dence linking suspected ibuprofen use to the
progression of pancreatic damage resulting in
pancreatitis.3-5 It is evident that the first injury
was caused by cephalexin, followed by con-
tinued injury from doxycycline and ibuprofen.
Language: en |