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Clinical Characterization and Diagnostic Approaches for Patients Reporting Hypersensitivity Reactions to Quinolones

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Clinical Characterization and Diagnostic Approaches for Patients Reporting Hypersensitivity Reactions to Quinolones

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dc.contributor.author Doña, Inmaculada es_ES
dc.contributor.author Pérez-Sánchez, Natalia es_ES
dc.contributor.author Salas, María es_ES
dc.contributor.author Barrionuevo, Esther es_ES
dc.contributor.author Ruiz-San Francisco, Arturo es_ES
dc.contributor.author Hernández Fernández de Rojas, Dolores es_ES
dc.contributor.author Martí-Garrido, Jaume es_ES
dc.contributor.author Andreu Ros, María Inmaculada es_ES
dc.contributor.author López-Salgueiro, Ramón es_ES
dc.contributor.author Moreno, Esther es_ES
dc.contributor.author Torres, María José es_ES
dc.date.accessioned 2021-07-27T03:38:09Z
dc.date.available 2021-07-27T03:38:09Z
dc.date.issued 2020-09 es_ES
dc.identifier.uri http://hdl.handle.net/10251/170289
dc.description.abstract [EN] BACKGROUND: Quinolones are the second most frequent cause of hypersensitivity reactions (HSRs) to antibiotics. A marked increase in the number of patients with HSRs to quinolones has been detected. OBJECTIVE: To describe the clinical characteristics of patients with HSRs to quinolones and present methods for their diagnosis. METHODS: Patients attending the allergy unit due to reactions suggestive of HSRs to quinolones were prospectively evaluated between 2005 and 2018. Diagnosis was achieved using clinical history, skin tests (STs), basophil activation tests (BATs), and drug provocation tests (DPTs) if ST and BAT results were negative. RESULTS: We included 128 subjects confirmed as having HSRs to quinolones and 42 found to be tolerant. Anaphylaxis was the most frequent entity in immediate HSRs and was most commonly induced by moxifloxacin. Patients were evaluated a median of 150 days (interquartile range, 60-365 days) after the reaction. Of patients who underwent ST and BAT, 40.7% and 70%, respectively, were positive. DPT with a quinolone was performed in 48 cases, giving results depending on the culprit drug: when moxifloxacin was involved, 62.5% of patients gave a positive DPT result to ciprofloxacin, whereas none reacted to levofloxacin. The risk of HSR was 96 times higher in subjects who reported moxifloxacin-induced anaphylaxis and 18 times higher in those reporting immediate reactions compared with clinical entities induced by quinolones other than moxi-floxacin and nonimmediate reactions. CONCLUSIONS: The diagnosis of HSR to quinolones is complex. The use of clinical history is essential as a first step. BAT shows higher sensitivity than STs. DPTs can be useful for finding safe alternative quinolones. es_ES
dc.description.sponsorship The present study has been supported by the Institute of Health "Carlos III" of the Ministry of Economy and Competitiveness (grants cofounded by European Regional Development Fund: RETIC ARADYALRD16/0006/0001, RD16/0006/0010, RD16/0006/0019, and RD16/0006/0030). I.D. is a clinical investigator (B0001-2017) from Consejeria de Salud of the Andalusian government, Junta de Andalucia. N.P.-S. holds a Rio Hortega research contract (CM17/0014), and E.B. a Juan Rodes research contract (JR18/00049), both from the Institute of Health "Carlos III," Spanish Ministry of Economy and Competitiveness (grants cofounded by the European Social Fund). es_ES
dc.language Inglés es_ES
dc.publisher Elsevier es_ES
dc.relation MINECO/RD16/0006/0010 es_ES
dc.relation MINECO/RD16/0006/0019 es_ES
dc.relation MINECO/RD16/0006/0030 es_ES
dc.relation.ispartof Journal of Allergy and Clinical Immunology: In Practice es_ES
dc.rights Reserva de todos los derechos es_ES
dc.subject Adverse drug reaction es_ES
dc.subject Anaphylaxis es_ES
dc.subject Basophil activation test es_ES
dc.subject Ciprofloxacin es_ES
dc.subject Drug provocation test es_ES
dc.subject Hypersensitivity es_ES
dc.subject Levofloxacin es_ES
dc.subject Moxifloxacin es_ES
dc.subject Quinolones es_ES
dc.subject Skin tests es_ES
dc.subject.classification QUIMICA ORGANICA es_ES
dc.title Clinical Characterization and Diagnostic Approaches for Patients Reporting Hypersensitivity Reactions to Quinolones es_ES
dc.type Artículo es_ES
dc.identifier.doi 10.1016/j.jaip.2020.04.051 es_ES
dc.relation.projectID info:eu-repo/grantAgreement/ISCIII//CM17%2F0014/ es_ES
dc.relation.projectID info:eu-repo/grantAgreement/MINECO//RD16%2F0006%2F0001/ES/Asma, Reacciones Adversas y Alérgicas (ARADYAL)/ es_ES
dc.rights.accessRights Abierto es_ES
dc.contributor.affiliation Universitat Politècnica de València. Departamento de Química - Departament de Química es_ES
dc.description.bibliographicCitation Doña, I.; Pérez-Sánchez, N.; Salas, M.; Barrionuevo, E.; Ruiz-San Francisco, A.; Hernández Fernández De Rojas, D.; Martí-Garrido, J.... (2020). Clinical Characterization and Diagnostic Approaches for Patients Reporting Hypersensitivity Reactions to Quinolones. Journal of Allergy and Clinical Immunology: In Practice. 8(8):2707-2714. https://doi.org/10.1016/j.jaip.2020.04.051 es_ES
dc.description.accrualMethod S es_ES
dc.relation.publisherversion https://doi.org/10.1016/j.jaip.2020.04.051 es_ES
dc.description.upvformatpinicio 2707 es_ES
dc.description.upvformatpfin 2714 es_ES
dc.type.version info:eu-repo/semantics/publishedVersion es_ES
dc.description.volume 8 es_ES
dc.description.issue 8 es_ES
dc.identifier.eissn 2213-2198 es_ES
dc.identifier.pmid 32376487 es_ES
dc.relation.pasarela S\435454 es_ES
dc.contributor.funder European Social Fund es_ES
dc.contributor.funder Instituto de Salud Carlos III es_ES
dc.contributor.funder European Regional Development Fund es_ES
dc.contributor.funder Ministerio de Economía y Competitividad es_ES
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