Fluoroquinolone Photodegradation Influences Specific Basophil Activation

Mayorga, Cristobalina; Andreu, Inmaculada; Aranda, Ana; Doña, Inmaculada; Montañez, María Isabel; Blanca‐López, Natalia; Ariza, Adriana; Nuin, Edurne; Blanca, Miguel; Miranda, Miguel A.; Torres, Marı́a José

doi:10.1159/000343023

Cited by 26 publications

(26 citation statements)

References 25 publications

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“… Although commercially available tests exist, BAT protocols are not standardized between different laboratories in terms of markers, procedures and drug concentrations . In vitro drug‐sIgE decreases with time , and therefore, the assay should be performed within 3 years of the reaction (LE 2++) (GR B). Up to 10% of patients can be ‘nonresponders’, and in these cases, BAT results cannot be interpreted (LE 2) (GR B). In fluoroquinolones, photodegradation may influence BAT results, especially for moxifloxacin (LE 3). …”

Section: In Vitro Diagnostic Testsmentioning

confidence: 99%

In vitrotests for drug hypersensitivity reactions: anENDA/EAACIDrug Allergy Interest Group position paper

Mayorga

Çelik

Rouzaire

et al. 2016

Allergy

261

353

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Drug hypersensitivity reactions (DHRs) are a matter of great concern, both for outpatient and in hospital care. The evaluation of these patients is complex, because in vivo tests have a suboptimal sensitivity and can be time-consuming, expensive and potentially risky, especially drug provocation tests. There are several currently available in vitro methods that can be classified into two main groups: those that help to characterize the active phase of the reaction and those that help to identify the culprit drug. The utility of these in vitro methods depends on the mechanisms involved, meaning that they cannot be used for the evaluation of all types of DHRs. Moreover, their effectiveness has not been defined by a consensus agreement between experts in the field. Thus, the European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology has organized a task force to provide data and recommendations regarding the available in vitro methods for DHR diagnosis. We have found that although there are many in vitro tests, few of them can be given a recommendation of grade B or above mainly because there is a lack of well-controlled studies, most information comes from small studies with few subjects and results are not always confirmed in later studies. Therefore, it is necessary to validate the currently available in vitro tests in a large series of well-characterized patients with DHR and to develop new tests for diagnosis.

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Section: In Vitro Diagnostic Testsmentioning

confidence: 99%

In vitrotests for drug hypersensitivity reactions: anENDA/EAACIDrug Allergy Interest Group position paper

Mayorga

Çelik

Rouzaire

et al. 2016

Allergy

261

353

View full text Add to dashboard Cite

show abstract

“…Additional studies have been performed for fluoroquinolones (FQs) [31,40,52,53], pyrazolones [54,55,56] and RCM [57,58] (Table 2). The analyses of these studies, taken together, show an average sensitivity of 59.4%, specificity of 94.6% and PPV and NPV of 93.4% and 66.3%, respectively.…”

Section: Ige-mediated Reactionsmentioning

confidence: 99%

The Value of In Vitro Tests to Diminish Drug Challenges

Mayorga

Doña

Pérez‐Inestrosa

et al. 2017

IJMS

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Drug hypersensitivity reactions have multiple implications for patient safety and health system costs, thus it is important to perform an accurate diagnosis. The diagnostic procedure includes a detailed clinical history, often unreliable; followed by skin tests, sometimes with low sensitivity or unavailable; and drug provocation testing, which is not risk-free for the patient, especially in severe reactions. In vitro tests could help to identify correctly the responsible agent, thus improving the diagnosis of these reactions, helping the physician to find safe alternatives, and reducing the need to perform drug provocation testing. However, it is necessary to confirm the sensitivity, specificity, negative and positive predictive values for these in vitro tests to enable their implementation in clinical practice. In this review, we have analyzed these parameters from different studies that have used in vitro test for evaluating drug hypersensitivity reactions and estimated the added value of these tests to the in vivo diagnosis.

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“…The most important is photo-degradation of the FQ molecules, since moxifloxacin has a higher rate of photodegradation than ciprofloxacin. Indeed, performing the test in dark compared to light conditions increases sensitivity from 17.9% to 35.7% 60. A recent study has highlighted the importance of the choice of activation marker.…”

Section: Introductionmentioning

confidence: 99%

In Vitro Diagnostic Testing for Antibiotic Allergy

Doña

Torres

Montañez

et al. 2017

Allergy Asthma Immunol Res

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Allergy to antibiotics is an important worldwide problem, with an estimated prevalence of up to 10% of the population. Reaction patterns for different antibiotics have changed in accordance with consumption trends. Most of the allergic reactions to antibiotics have been reported for betalactams, followed by quinolones and macrolides and, to a lesser extent, to others, such as metronidazole clindamycin and sulfonamides. The diagnostic procedure includes a detailed clinical history, which is not always possible and can be unreliable. This is usually followed by in vivo, skin, and drug provocation tests. These are not recommended for severe, potentially lifethreaten reactions or for drugs that are known to produce a high rate of false positive results. Given the limitations of in vivo tests, in vitro test can be helpful for diagnosis, despite having suboptimal sensitivity. The most highly employed techniques for diagnosing immediate reactions to antibiotics are immunoassays and basophil activation tests, while lymphocyte transformation tests are more commonly used to diagnose non-immediate reactions. In this review, we describe different in vitro techniques employed to diagnose antibiotic allergy.

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Fluoroquinolone Photodegradation Influences Specific Basophil Activation

Cited by 26 publications

References 25 publications

In vitrotests for drug hypersensitivity reactions: anENDA/EAACIDrug Allergy Interest Group position paper

In vitrotests for drug hypersensitivity reactions: anENDA/EAACIDrug Allergy Interest Group position paper

The Value of In Vitro Tests to Diminish Drug Challenges

In Vitro Diagnostic Testing for Antibiotic Allergy

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