McGee Edoabasi U, Samuel Essie, Boronea Bernadett, Dillard Nakoasha, Milby Madison N, Lewis Susan J
School of Pharmacy, Philadelphia College of Osteopathic Medicine, Suwanee, GA 30024, USA.
College of Pharmacy, University of Findlay, Findlay, OH 45840, USA.
Pharmacy (Basel). 2019 Jul 19;7(3):97. doi: 10.3390/pharmacy7030097.
Quinolones are the second most common antibiotic class associated with drug-induced allergic reactions, but data on quinolone allergy are scarce. This review article discusses the available evidence on quinolone allergy, including prevalence, risk factors, diagnosis, clinical manifestations, cross-reactivity, and management of allergic reactions. Although the incidence of quinolone allergy is still lower than beta-lactams, it has been increasingly reported in recent decades, most likely from its expanded use and the introduction of moxifloxacin. Thorough patient history remains essential in the evaluation of quinolone allergy. Many diagnostic tools have been investigated, but skin tests can yield false-positive results and in vitro tests have not been validated. The drug provocation test is considered the test of choice to confirm a quinolone allergy but is not without risk. Evidence regarding cross-reactivity among the quinolones is limited and conflicting. Quinolone allergy can be manifested either as an immediate or delayed reaction, but is not uniform across the class, with moxifloxacin posing the highest risk of anaphylaxis. Quinolone should be discontinued when an allergic reaction occurs and avoided in future scenarios, but desensitization may be warranted if no alternatives are available.
喹诺酮类药物是与药物性过敏反应相关的第二常见抗生素类别，但关于喹诺酮类药物过敏的数据却很稀少。这篇综述文章讨论了关于喹诺酮类药物过敏的现有证据，包括患病率、风险因素、诊断、临床表现、交叉反应以及过敏反应的管理。尽管喹诺酮类药物过敏的发生率仍低于β-内酰胺类药物，但近几十年来其报告越来越多，这很可能是由于其使用范围扩大以及莫西沙星的引入。在评估喹诺酮类药物过敏时，详尽的患者病史仍然至关重要。已经对许多诊断工具进行了研究，但皮肤试验可能会产生假阳性结果，而体外试验尚未得到验证。药物激发试验被认为是确认喹诺酮类药物过敏的首选试验，但并非没有风险。关于喹诺酮类药物之间交叉反应的证据有限且相互矛盾。喹诺酮类药物过敏可表现为即刻反应或延迟反应，但在整个类别中并不一致，其中莫西沙星引起过敏反应的风险最高。发生过敏反应时应停用喹诺酮类药物，并且在未来应避免使用，但如果没有其他替代品，脱敏治疗可能是必要的。
