In-Class Cross-Reactivity among Hospitalized Patients with Hypersensitivity Reactions to Fluoroquinolones

Shah, Sunish; Clarke, Lloyd; Adams, Kathleen

doi:10.1128/aac.00374-23

Cited by 2 publications

(1 citation statement)

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“…Shah et al's findings from a recent large, multicenter, retrospective study suggest that patients with confirmed ciprofloxacin, moxifloxacin, or levofloxacin HRs may tolerate other fluoroquinolones. Seventy percent of patients in the study were challenged with a different fluoroquinolones, but only nine (5.6%) patients experienced hypersensitivity [21]. Similarly to our patient, a case report published in Elsevier Espana in 2012 presents a patient who developed an anaphylactic reaction to levofloxacin, but tolerated ciprofloxacin four weeks afterwards [22].…”

Section: Discussionsupporting

confidence: 73%

Ciprofloxacin-Induced Anaphylactic Reaction Followed by Negative Provocation Test in Response to Levofloxacin: A Case Report

Kurtov,

Kilić,

Ikić

et al. 2023

Medicina

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Fluoroquinolones are a commonly prescribed class of antibiotics due to their broad spectrum of antimicrobial activity, favorable pharmacokinetic properties, ability to switch from parenteral to oral administration, and global availability. After beta-lactams, they are the second most common antibiotic class associated with drug allergies. The mechanism of fluoroquinolone-induced hypersensitivity reactions has not yet been fully understood, so the true incidence of hypersensitivity reactions remains unknown. Cross-reactivity between fluoroquinolones has been the subject of conflicting and limited clinical research. Due to their similar chemical structure, some argue for close cross-reactivity within the group. However, recent studies have produced contradictory results. We present the case of a young patient who had an anaphylactic reaction to ciprofloxacin but was tolerant to levofloxacin, as determined via a skin prick test followed by a drug provocation test. Our findings support the notion that there is little cross-reactivity between fluoroquinolones. Consequently, exposure to another fluoroquinolone in a hospital setting may be beneficial, particularly for patients who lack adequate antibiotic alternatives. However, additional research on this subject is required.

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Section: Discussionsupporting

confidence: 73%