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An event is serious (based on the ICH definition) when the patient outcome is:
* death
* life-threatening
* hospitalisation
* disability
* congenital anomaly
* other medically important event
A 54-year-old man developed acute urticaria during off treatment with ceftriaxone and hydroxychloroquine for Coronavirus disease 2019 (COVID-19). Additionally, the treatment with azithromycin also contributed in the development of acute urticaria [routes not stated; not all dosages stated].
The man was admitted with dry cough, difficulty breathing and fever. Following examinations, he was diagnosed with COVID-19. He was treated with hydroxychloroquine (400mg twice daily on the first day, followed by 200mg twice daily), ceftriaxone 1000mg twice daily and oxygen therapy. After 14 days of treatment, his oro-pharyngeal and nasal swab tests found to be negative. Subsequently, he was discharged from the hospital and prescribed azithromycin for the next 5 days. Two days after completing the azithromycin course and 3 weeks after completion of ceftriaxone and hydroxychloroquine therapy, he developed pruritic sensation, an acute episode of erythematous elements and intensive itching. The next day, he developed hives over his legs, back and trunk. He had no history of hives, allergies, autoimmune disease or thyroid. He had a positive dermographism. Clinical examination showed itching and whealing. Based on these clinical presentation a diagnosis of acute urticaria was made.
The man was treated with unspecified corticosteroids and antihistamine successfully with good control of itching and wheals.