The Role of in Vivo Tests in the Diagnosis of Hypersensitivity Reactions Due to Quinolones and Their Importance in Cross-Reactions

Abstract

INTRODUCTION: There are conflicting results regarding the sensitivity of skin tests and cross-reactions between quinolones in quinolone allergy. In our study, we aimed to evaluate the results of skin tests and provocation tests performed with quinolones and to investigate the value of these tests in the diagnosis of hypersensitivity reactions due to quinolones and their usefulness in detecting possible cross-reactions between quinolones. METHODS: We analyzed the file records of the patients who applied to our clinic for the reason of antibiotic drug allergy and who underwent diagnostic or alternative in vivo diagnostic tests with quinolone group drugs between January 2006 and September 2020. We recorded and evaluated the results of these cases with demographic characteristics such as age, gender, atopy history, concomitant allergic diseases, suspected antibiotic(s), allergic reaction type and time of occurrence, skin tests for diagnosis, and drug provocation tests. RESULTS: The study included 715 patients, 73.56% of whom were women. Of the patients, 92.72% had a history of early-type drug allergic reactions. Skin tests had been applied to 219 patients. Of the 119 skin tests performed for diagnostic purposes, 48 were positive. A provocation test was performed in 31 of these patients whose skin test was found to be sensitive; 27 of them were negative. In 47 patients, 83 safe cross-over alternative drugs were obtained through provocation tests. DISCUSSION AND CONCLUSION: Provocation tests are necessary for the diagnosis of quinolone hypersensitivity reaction and in the evaluation of cross-reactivity. Before provocation tests, evaluation should be made with skin tests.

Keywords

• antibiotics
• cross-reactions
• hypersensitivity reactions
• quinolones.