Department of Clinical Pharmacology and Toxicology, University Hospital Sveti Duh, 10000 Zagreb, Croatia.
Department of Clinical Immunology, Rheumatology, and Pulmonology, University Hospital Sveti Duh, 10000 Zagreb, Croatia.
Medicina (Kaunas). 2023 Oct 7;59(10):1784. doi: 10.3390/medicina59101784.
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.
氟喹诺酮类药物由于其广谱的抗菌活性、良好的药代动力学特性、从注射给药到口服给药的转换能力以及全球供应而被广泛用于临床。它们是继β-内酰胺类药物之后第二常见的与药物过敏相关的抗生素类别。氟喹诺酮类药物引起的超敏反应的机制尚未完全阐明，因此超敏反应的真实发生率尚不清楚。氟喹诺酮类药物之间的交叉反应一直是存在争议和有限的临床研究的主题。由于它们具有相似的化学结构，一些人认为该组内存在密切的交叉反应。然而，最近的研究结果却相互矛盾。我们报告了一例年轻患者对环丙沙星发生过敏反应，但皮试和药物激发试验后对左氧氟沙星耐受。我们的发现支持了这样一种观点，即氟喹诺酮类药物之间的交叉反应性很小。因此，在医院环境中接触另一种氟喹诺酮类药物可能是有益的，特别是对于那些缺乏足够抗生素替代药物的患者。然而，需要对此主题进行更多的研究。
