RT Journal Article
T1 Clinical Characterization and Diagnostic Approaches for Patients Reporting Hypersensitivity Reactions to Quinolones.
A1 Doña, Inmaculada
A1 Perez-Sanchez, Natalia
A1 Salas, Maria
A1 Barrionuevo, Esther
A1 Ruiz-San Francisco, Arturo
A1 Hernandez-Fernandez-de-Rojas, Dolores
A1 Marti-Garrido, Jaume
A1 Andreu-Ros, Inmaculada
A1 Lopez-Salgueiro, Ramon
A1 Moreno, Esther
A1 Torres, Maria Jose
K1 Adverse drug reaction
K1 Anaphylaxis
K1 Basophil activation test
K1 Ciprofloxacin
K1 Drug provocation test
K1 Hypersensitivity
K1 Levofloxacin
K1 Moxifloxacin
K1 Quinolones
K1 Skin tests
AB Quinolones are the second most frequent cause of hypersensitivity reactions (HSRs) to antibiotics. A marked increase in the number of patients with HSRs to quinolones has been detected. To describe the clinical characteristics of patients with HSRs to quinolones and present methods for their diagnosis. Patients attending the allergy unit due to reactions suggestive of HSRs to quinolones were prospectively evaluated between 2005 and 2018. Diagnosis was achieved using clinical history, skin tests (STs), basophil activation tests (BATs), and drug provocation tests (DPTs) if ST and BAT results were negative. We included 128 subjects confirmed as having HSRs to quinolones and 42 found to be tolerant. Anaphylaxis was the most frequent entity in immediate HSRs and was most commonly induced by moxifloxacin. Patients were evaluated a median of 150 days (interquartile range, 60-365 days) after the reaction. Of patients who underwent ST and BAT, 40.7% and 70%, respectively, were positive. DPT with a quinolone was performed in 48 cases, giving results depending on the culprit drug: when moxifloxacin was involved, 62.5% of patients gave a positive DPT result to ciprofloxacin, whereas none reacted to levofloxacin. The risk of HSR was 96 times higher in subjects who reported moxifloxacin-induced anaphylaxis and 18 times higher in those reporting immediate reactions compared with clinical entities induced by quinolones other than moxifloxacin and nonimmediate reactions. The diagnosis of HSR to quinolones is complex. The use of clinical history is essential as a first step. BAT shows higher sensitivity than STs. DPTs can be useful for finding safe alternative quinolones.
PB Elsevier
YR 2020
FD 2020-05-04
LK http://hdl.handle.net/10668/15518
UL http://hdl.handle.net/10668/15518
LA en
NO Doña I, Pérez-Sánchez N, Salas M, Barrionuevo E, Ruiz-San Francisco A, Hernández Fernández de Rojas D, et al. Clinical Characterization and Diagnostic Approaches for Patients Reporting Hypersensitivity Reactions to Quinolones. J Allergy Clin Immunol Pract. 2020 Sep;8(8):2707-2714.e2
NO RETIC ARADYAL RD16/0006/0001, RD16/0006/0010, RD16/0006/0019, and RD16/0006/0030). I.D. is a clinical investigator (B0001-2017) from Consejería de Salud of the Andalusian government, Junta de Andalucía. N.P.-S. holds a Rio Hortega research contract (CM17/0014), and E.B. a Juan Rodes research contract (JR18/00049), both from the Institute of Health “Carlos III,” Spanish Ministry of Economy and Competitiveness (grants co-financed by the European Social Fund).
DS RISalud
RD Apr 17, 2025