Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Quinolones
| Autor: | P Gajate, Ignacio Garcia-Nunez, Inmaculada Doña, A. Rosado, Natalia Blanca-López, C Boteanu, Esther Moreno, P Rojas, F J Fernández-Sánchez, T Lobera, B Cueva-Oliver, M C García-Avilés |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Allergy Drug-Related Side Effects and Adverse Reactions medicine.drug_class medicine.medical_treatment Immunology Provocation test Drug allergy Antibiotics Basophil activation test Basophil Degranulation Test Quinolones Cross Reactions Drug Hypersensitivity 03 medical and health sciences Skin test 0302 clinical medicine Levofloxacin Anti-Allergic Agents medicine Immunology and Allergy Humans Intensive care medicine Anaphylaxis Desensitization (medicine) Skin Tests business.industry Gold standard (test) Allergens medicine.disease 030104 developmental biology Desensitization Immunologic 030220 oncology & carcinogenesis Practice Guidelines as Topic Drug provocation test business medicine.drug |
| Zdroj: | JOURNAL OF INVESTIGATIONAL ALLERGOLOGY AND CLINICAL IMMUNOLOGY r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante instname |
| ISSN: | 1018-9068 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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