Common Causes of Drug Fever | |
Class | Drugs |
Antimicrobials | Acyclovir, carbapenems, cephalosporins, tetracyclines, mebendazole, nitrofurantoin, penicillins, rifampin, sulfonamides, vancomycin |
Anticonvulsants | Barbiturates, carbamazepine, phenytoin |
Antidepressant | Doxepin, nomifensine |
Antineoplastic agents | 6-mercaptopurine, bleomycin, chlorambucil, cisplatin, arabinoside, daunorubicin, hydroxyurea, interferon, L-asparaginase, procarbazine, streptozocin, vincristine |
Cardiovascular drugs | Clofibrate, diltiazem, dobutamine, furosemide, heparin, hydralazine, hydrochlorothiazide, methyldopa, oxprenolol, procainamide, quinidine, triamterene |
Histamine-2 blockers | Cimetidine, ranitidine |
Immunosuppressants | Azathioprine, everolimus, mycophenolate, sirolimus |
NSAIDs | Ibuprofen, sulindac, phenothiazines, salicylates |
Other | Allopurinol, antihistamines, folate, herbal remedies, iodide, metoclopramide, piperazine, propylthiouracil, prostaglandin E2, ritodrine, sulfasalazine, sympathomimetics, theophylline, thyroxine |
Clues it Might be Drug Fever: · Early onset (7-10 days from first dose) · Unremitting pyrexia · Multiple negative blood cultures · Patient appears “inappropriately well” for degree of fever · Relative bradycardia for degree of fever · C-reactive protein level disproportionally low · Fever remits on drug withdrawal |
References:
Patel, R.A. and Gallagher, J.C. (2010), Drug Fever. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 30: 57-69. https://doi.org/10.1592/phco.30.1.57