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对氟喹诺酮类药物的速发型超敏反应:一项评估交叉反应性的队列研究

Immediate Hypersensitivity to Fluoroquinolones: 
A Cohort Assessing Cross-Reactivity.

作者信息

Azimi Sara F, Mainella Vincent, Jeffres Meghan N

机构信息

Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

出版信息

Open Forum Infect Dis. 2022 Mar 2;9(4):ofac106. doi: 10.1093/ofid/ofac106. eCollection 2022 Apr.

Abstract

BACKGROUND

Fluoroquinolones are the second-most prescribed antimicrobial and are frequently associated with causing hypersensitivity reactions. Existing evidence regarding cross-reactivity of fluoroquinolones is limited, offering clinicians little guidance in understanding the implications of selecting an in-class alternative among patients with histories of allergic reactions to fluoroquinolones. The aim of this study was to compare the frequency of immediate hypersensitivity reactions to ciprofloxacin, levofloxacin, and/or moxifloxacin among patients with a history of immediate hypersensitivity to a different fluoroquinolone.

METHODS

This retrospective chart review included adult patients with a history of an immediate hypersensitivity reaction to ciprofloxacin, levofloxacin, and/or moxifloxacin and a documented prescription for a different fluoroquinolone. The primary outcome was documentation of a hypersensitivity reaction upon second fluoroquinolone exposure.

RESULTS

A total of 321 cases met inclusion criteria. Of these cases, 2.5% experienced an immediate hypersensitivity reaction after second fluoroquinolone exposure to ciprofloxacin, levofloxacin, and/or moxifloxacin. Within the ciprofloxacin, levofloxacin, and moxifloxacin index allergy cohorts, the frequency of cross-reactivity was 2.5%, 2.0%, and 5.3%, respectively.

CONCLUSIONS

Our data suggest that patients with a history of immediate hypersensitivity reaction to ciprofloxacin, levofloxacin, and/or moxifloxacin are at low risk of experiencing a cross-reaction when exposed to a different fluoroquinolone. Avoidance of all fluoroquinolones in this patient population may not be warranted.

摘要

背景

氟喹诺酮类药物是第二大最常开具的抗菌药物,且经常与引起过敏反应相关。关于氟喹诺酮类药物交叉反应性的现有证据有限,这使得临床医生在理解对氟喹诺酮类药物有过敏反应病史的患者中选择同类替代药物的影响方面几乎没有指导。本研究的目的是比较对一种氟喹诺酮类药物有速发型过敏反应病史的患者中,对环丙沙星、左氧氟沙星和/或莫西沙星发生速发型过敏反应的频率。

方法

这项回顾性病历审查纳入了对环丙沙星、左氧氟沙星和/或莫西沙星有速发型过敏反应病史且有不同氟喹诺酮类药物处方记录的成年患者。主要结局是第二次接触氟喹诺酮类药物时过敏反应的记录。

结果

共有321例符合纳入标准。在这些病例中,2.5%的患者在第二次接触环丙沙星、左氧氟沙星和/或莫西沙星氟喹诺酮类药物后发生了速发型过敏反应。在环丙沙星、左氧氟沙星和莫西沙星索引过敏队列中,交叉反应的频率分别为2.5%、2.0%和5.3%。

结论

我们的数据表明,对环丙沙星、左氧氟沙星和/或莫西沙星有速发型过敏反应病史的患者在接触不同氟喹诺酮类药物时发生交叉反应的风险较低。在这一患者群体中避免使用所有氟喹诺酮类药物可能没有必要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e241/8962755/55d140f52ef4/ofac106_fig1.jpg

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