Update on Quinolone Allergy

Autores de IIS La Fe

• Inmaculada Andreu Ros

  Autor

• María Dolores Hernandez Fernandez De Rojas

  Autor

Participantes ajenos a IIS La Fe

• Doña I
• Moreno, E
• Perez-Sanchez, N
• Torres, MJ

Grupos

• Alergia y enfermedades respiratorias de la Infancia

  Investigador Principal

  Miguel Tortajada Girbés

• Unidad Mixta de Investigación en Mecanismos moleculares de las Reacciones adversas de fármacos

Abstract

. Purpose of Review Quinolones are a group of synthetic antibiotics widely use as first-line treatment for many infections. There has been an increase in the incidence of hypersensitivity reactions to quinolones in recent years, likely due to increased prescription. The purpose of this review is to summarize the clinical pictures, the methods used for diagnosing and the management of allergic reactions to quinolones. Recent Findings Allergic reactions to quinolones can be immediate or delayed, being anaphylaxis and maculopapular exanthema respectively the most frequent clinical entities. A precise diagnosis is particularly difficult since clinical history is often unreliable, skin tests can induce false-positive results, and commercial in vitro test are not well validated. Therefore, drug provocation testing is considered the gold standard to establish diagnosis, which is not a risk-free procedure. Cross-reactivity between quinolones is difficult to predict due to the small number of patients included in the few published studies. Moreover, hypersensitivity to quinolones has also been associated with beta-lactam and neuromuscular blocking agent allergies, although further studies are needed to understand the underlying mechanisms. Avoidance of the culprit quinolone is indicated in patients with a diagnosis of hypersensitivity to these drugs. When quinolone treatment is the only therapeutic option available, desensitization is necessary. Summary This review summarizes the complex diagnostic approach and management of allergic reactions to quinolones.

Keywords

• Anaphylaxis; Basophil activation test; Drug provocation test; Maculopapular exanthema; Quinolone; Skin test