SELECTED ARTICLES FROM THE RECENT LITERATURE 2005
9/14/05
Hypersensitivity to quinolone antibiotics
Summary
Background - Immediate hypersensitivity to fluoroquinolone (Flq) antibiotics occur very occasionally. Moxafloxacin (Mox) is a Flq chemically dissimilar to other Flq agents. Therefore, the question arises whether Mox would be tolerated by individuals allergic to other Flq agents.
Findings - Gonzalez et al of the Hospital San Milan in Spain evaluated 6 patients with histories suggesting immediate hypersensitivity to various Flq drugs. They found positive Mox skin test reactions in 5 of the 6 patients. All 6 patients had at least one positive skin test reaction to other Flq agents test. Single-blind oral challenges with Mox were positive in all patients regardless of which Flq was thought to be the previous offender in the patients' history.
Reference
J Investig Allergol Clin Immunol 2005;15:146-9
Editor's Comments
My impression is that typical immediate hypersensitivity reactions to Flq agents are very uncommon considering the very frequent use of agents in this antibiotic class. The findings in this study suggest: 1) skin testing with Flq agents may be diagnostically useful. Previously, the penicillin agents were the only antibiotics in which skin testing was really helpful; 2) Flq skin test responses were directed against allergens common to this class of antibiotics, not against individual Flq agents; 3) despite its chemical dissimilarity to other Flq, Mox should be avoided in those with histories of allergic reactions to other Flq agents.
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