González I, Lobera T, Blasco A, del Pozo M D
Section of Allergy. Hospital San Millán. San Pedro Logroño. La Rioja. Spain.
J Investig Allergol Clin Immunol. 2005;15(2):146-9.
Immediate hypersensitivity reactions to quinolones are rare. Moxifloxacin is an quinolone chemically different from other fluoroquinolones. We report 6 patients diagnosed with hypersensitivity to different fluoroquinolones in whom the response to moxifloxacin and cross-reactivity with other quinolones was studied.
MATERIAL-METHODS: An allergenic study was made by prick and intradermal test with different fluoroquinolones, in all the patients. Single blind oral challenge tests were performed with moxifloxacin in all the patients, with ciprofloxacin in five patients, with levofloxacin in three patients and with ofloxacin in one patient.
The skin test performed with moxifloxacin was positive in five patients, and the oral challenge test was positive in all six patients. All the patients had at least one positive skin test with some of the other fluoroquinolones.
The skin test with different quinolones seems to be sensitive at showing group hypersensitivity, but not at predicting specific tolerance of each drug. We found a high degree of cross-reactivity among fluoroquinolones, so we currently recommend to avoid the group. We did not find that moxifloxacin differed from other fluoroquinolones so we cannot recommend it as a valid therapeutic alternative in patients sensitized to other quinolones.
对喹诺酮类药物的速发型超敏反应较为罕见。莫西沙星是一种在化学结构上与其他氟喹诺酮类药物不同的喹诺酮类药物。我们报告了6例被诊断对不同氟喹诺酮类药物过敏的患者，并研究了他们对莫西沙星的反应以及与其他喹诺酮类药物的交叉反应性。
对所有患者进行了不同氟喹诺酮类药物的点刺试验和皮内试验以进行变应原研究。所有患者均进行了莫西沙星的单盲口服激发试验，5例患者进行了环丙沙星的口服激发试验，3例患者进行了左氧氟沙星的口服激发试验，1例患者进行了氧氟沙星的口服激发试验。
5例患者的莫西沙星皮肤试验呈阳性，所有6例患者的口服激发试验均呈阳性。所有患者对某些其他氟喹诺酮类药物的皮肤试验至少有一项呈阳性。
不同喹诺酮类药物的皮肤试验似乎对显示群体超敏反应敏感，但对预测每种药物的特异性耐受性不敏感。我们发现氟喹诺酮类药物之间存在高度交叉反应性，因此我们目前建议避免使用该类药物。我们未发现莫西沙星与其他氟喹诺酮类药物有差异，因此我们不能推荐它作为对其他喹诺酮类药物过敏患者的有效治疗替代药物。
