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Original Article

Hypersensitivity reactions to fluoroquinolones: analysis of the factors involved

  1. N. Blanca-López1,
  2. A. Ariza2,
  3. I. Doña3,
  4. C. Mayorga2,
  5. M. I. Montañez2,
  6. J. Garcia-Campos3,
  7. F. Gomez3,
  8. C. Rondón3,
  9. M. Blanca3,
  10. M. J. Torres3,*

Article first published online: 22 APR 2013

DOI: 10.1111/cea.12099

Issue

Clinical & Experimental Allergy

Clinical & Experimental Allergy

Volume 43, Issue 5, pages 560–567, May 2013

Additional Information

How to Cite

N. Blanca-López, A. Ariza, I. Doña, C. Mayorga, M. I. Montañez, J. Garcia-Campos, F. Gomez, C. Rondón, M. Blanca, M. J. Torres, Clinical & Experimental Allergy, 2013 (43) 560–567.

Author Information

  1. 1

    Allergy Service, Infanta Leonor Hospital, Madrid, Spain

  2. 2

    Research Laboratory for Allergic Diseases, Carlos Haya Hospital, Malaga, Spain

  3. 3

    Allergy Service, Carlos Haya Hospital, Malaga, Spain

* Correspondence:
Maria José Torres Jaén, Allergy Service, Pabellón 6, Primera Planta. Carlos Haya Hospital (Pabellon C). Plaza del Hospital Civil. 29009 Malaga, Spain.
E-mail: mjtorresj@gmail.com.

Publication History

  1. Issue published online: 22 APR 2013
  2. Article first published online: 22 APR 2013
  3. Accepted manuscript online: 14 FEB 2013 10:30AM EST
  4. Manuscript Accepted: 28 JAN 2013
  5. Manuscript Revised: 27 JAN 2013
  6. Manuscript Received: 5 JUL 2012

Funded by

  • FIS-Thematic Networks and Co-operative Research Centres. Grant Number: RIRAAF/RD07/0064
  • Junta de Andalucia. Grant Numbers: CTS 06603, PI-0545-2010
  • FIS. Grant Number: 09/01768

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Keywords:

  • allergy;
  • anaphylaxis;
  • fluoroquinolones;
  • IgE;
  • penicillin

Summary

Background

Hypersensitivity reactions to fluoroquinolones seem to be on the increase, especially immediate type reactions.

Objective

The aim of this study was to determine whether several conditions, including gender, age, type of reaction, time interval between the reaction and the study, type of symptoms, the specific fluoroquinolone involved in the reaction and previous confirmed hypersensitivity to betalactams or to other drugs were factors contributing to the development of hypersensitivity to fluoroquinolones.

Method

We analysed retrospectively all patients attending our allergy department between January 2005 and December 2010 because of a reaction associated with fluoroquinolone administration. The diagnosis was confirmed by basophil activation test or drug provocation tests. In accordance with the results, patients were then classified as having hypersensitivity or non-hypersensitivity to fluoroquinolones.

Results

A group of 218 patients was evaluated; 69 were confirmed as having hypersensitivity, 146 as non-hypersensitivity and 3 were excluded. Comparisons between groups showed that the allergic patients more often had a previous confirmed hypersensitivity to betalactams (P = 0.029), immediate reactions (P = 0.001) and anaphylaxis (P = 0.000), and moxifloxacin was the fluoroquinolone most frequently involved (P = 0.027). The logistic regression analysis showed three factors associated with the diagnosis of hypersensitivity reactions to fluoroquinolones: previous hypersensitivity to betalactams (OR: 4.571; 95% CI: 0.987–21.171; adjusted OR: 23.654; 95% CI: 1.529–365.853), immediate reactions (OR: 17.333; 95% CI: 4.374–68.691; adjusted OR: 52.493; 95% CI: 6.621–416.200) and reactions induced by moxifloxacin (OR: 3.091; 95% CI: 1.160–8.239; adjusted OR: 13.610; 95% CI: 2.419–76.565).

Conclusion

In patients who develop reactions to fluoroquinolones, hypersensitivity is more often confirmed in those with immediate reactions and when moxifloxacin is involved. Moreover, patients with hypersensitivity to betalactams are more prone to develop hypersensitivity reactions to fluoroquinolones.

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