Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Quinolones.

The consumption of quinolones as first-line treatment has increased in recent years, leading to an increase in the incidence of hypersensitivity reactions (HSRs) to this antibiotic group. Both diagnosis and management of HSRs to quinolones are complex and controversial. These practical guidelines ai...

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Autores: Doña I, Blanca-López N, Boteanu C, Cueva-Oliver B, Fernández-Sánchez FJ, Gajate P, García-Avilés MC, García-Núñez I, Lobera T, Moreno E, Rojas P, Rosado A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p7354
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones7354
Access Level:acceso abierto
Palabra clave:Anaphylaxis
Basophil activation test
Drug allergy
Drug provocation test
Quinolones
Skin test
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spelling Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Quinolones.Doña IBlanca-López NBoteanu CCueva-Oliver BFernández-Sánchez FJGajate PGarcía-Avilés MCGarcía-Núñez ILobera TMoreno ERojas PRosado AAnaphylaxisBasophil activation testDrug allergyDrug provocation testQuinolonesSkin testThe consumption of quinolones as first-line treatment has increased in recent years, leading to an increase in the incidence of hypersensitivity reactions (HSRs) to this antibiotic group. Both diagnosis and management of HSRs to quinolones are complex and controversial. These practical guidelines aim to provide recommendations for effective clinical practice. The recommendations were drafted by an expert panel that reviewed the literature regarding HSRs to quinolones and analyzed controversies in this area. Most HSRs to quinolones are immediate and severe. The risk for HSRs is higher in patients who report allergy to ß-lactams, moxifloxacininduced anaphylaxis, and immediate reactions than in patients who report reactions to quinolones inducing other symptoms. The usefulness of skin tests in diagnosing HSRs to quinolones is controversial, with sensitivity and specificity varying between studies. Most in vitro tests are produced in-house, with no validated commercial options. The basophil activation test has proven useful for diagnosing immediate reactions, albeit with diverse results regarding sensitivity. Drug provocation testing is currently the gold standard for confirming or excluding the diagnosis and for finding safe alternatives, although it is contraindicated in patients with severe reactions. Cross-reactivity between quinolones has proven controversial in several studies, with the lowest cross-reactivity reported for levofloxacin. Desensitization may be considered in allergy to quinolones when no other alternatives are available.ESMON PUBLICIDAD S A, DEPT ALLERGY & CLIN IMMUNOL, CLIN UNIV NAVARRA2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones7354JOURNAL OF INVESTIGATIONAL ALLERGOLOGY AND CLINICAL IMMUNOLOGYISSN: 10189068ISSNe: 16980808reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p73542026-06-12T10:20:37Z
dc.title.none.fl_str_mv Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Quinolones.
title Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Quinolones.
spellingShingle Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Quinolones.
Doña I
Anaphylaxis
Basophil activation test
Drug allergy
Drug provocation test
Quinolones
Skin test
title_short Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Quinolones.
title_full Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Quinolones.
title_fullStr Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Quinolones.
title_full_unstemmed Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Quinolones.
title_sort Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Quinolones.
dc.creator.none.fl_str_mv Doña I
Blanca-López N
Boteanu C
Cueva-Oliver B
Fernández-Sánchez FJ
Gajate P
García-Avilés MC
García-Núñez I
Lobera T
Moreno E
Rojas P
Rosado A
author Doña I
author_facet Doña I
Blanca-López N
Boteanu C
Cueva-Oliver B
Fernández-Sánchez FJ
Gajate P
García-Avilés MC
García-Núñez I
Lobera T
Moreno E
Rojas P
Rosado A
author_role author
author2 Blanca-López N
Boteanu C
Cueva-Oliver B
Fernández-Sánchez FJ
Gajate P
García-Avilés MC
García-Núñez I
Lobera T
Moreno E
Rojas P
Rosado A
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Anaphylaxis
Basophil activation test
Drug allergy
Drug provocation test
Quinolones
Skin test
topic Anaphylaxis
Basophil activation test
Drug allergy
Drug provocation test
Quinolones
Skin test
description The consumption of quinolones as first-line treatment has increased in recent years, leading to an increase in the incidence of hypersensitivity reactions (HSRs) to this antibiotic group. Both diagnosis and management of HSRs to quinolones are complex and controversial. These practical guidelines aim to provide recommendations for effective clinical practice. The recommendations were drafted by an expert panel that reviewed the literature regarding HSRs to quinolones and analyzed controversies in this area. Most HSRs to quinolones are immediate and severe. The risk for HSRs is higher in patients who report allergy to ß-lactams, moxifloxacininduced anaphylaxis, and immediate reactions than in patients who report reactions to quinolones inducing other symptoms. The usefulness of skin tests in diagnosing HSRs to quinolones is controversial, with sensitivity and specificity varying between studies. Most in vitro tests are produced in-house, with no validated commercial options. The basophil activation test has proven useful for diagnosing immediate reactions, albeit with diverse results regarding sensitivity. Drug provocation testing is currently the gold standard for confirming or excluding the diagnosis and for finding safe alternatives, although it is contraindicated in patients with severe reactions. Cross-reactivity between quinolones has proven controversial in several studies, with the lowest cross-reactivity reported for levofloxacin. Desensitization may be considered in allergy to quinolones when no other alternatives are available.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://isabial.portalinvestigacion.com/publicaciones7354
url https://isabial.portalinvestigacion.com/publicaciones7354
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ESMON PUBLICIDAD S A, DEPT ALLERGY & CLIN IMMUNOL, CLIN UNIV NAVARRA
publisher.none.fl_str_mv ESMON PUBLICIDAD S A, DEPT ALLERGY & CLIN IMMUNOL, CLIN UNIV NAVARRA
dc.source.none.fl_str_mv JOURNAL OF INVESTIGATIONAL ALLERGOLOGY AND CLINICAL IMMUNOLOGY
ISSN: 10189068
ISSNe: 16980808
reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
repository.name.fl_str_mv
repository.mail.fl_str_mv
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