ASSESSMENT OF POTENTIAL CROSS-REACTIVITY REACTIONS AND CHARACTERISTICS OF HOSPITAL INPATIENTS CLAIMING A QUINOLONE DRUG ALLERGY

Introduction

While penicillin allergy research has established the crucial utility of accurate registration of prevalence, characteristics, and diagnosis of ß-lactam allergy, other types of antibiotic allergies have only been partially investigated. The primary objective of this study is to better assess quinolone cross-reactivity.

Methods

A retrospective chart review was performed for all adult inpatients with an index documented history of immediate hypersensitivity to quinolone(s) who received a subsequent systemic quinolone. The primary outcome was immediate hypersensitivity reaction to a second quinolone other than the index quinolone allergy.

Results

A total of 54 cases met inclusion criteria, with a mean age of 67 years old, 74.1% female, and average hospital LOS 3.8 days. Index fluoroquinolone allergy history, in order of prevalence, included rash, hives, anaphylaxis, tendonitis, syncope, unknown, mental status changes, and hemolytic anemia. Of the 54 cases, 3.7% (2/54) experienced an immediate hypersensitivity reaction after second quinolone exposure to ciprofloxacin, levofloxacin, and/or moxifloxacin. Within the ciprofloxacin, levofloxacin, and moxifloxacin index allergy cohorts, the frequency of cross-reactivity was 0% for each index allergy cohort (0/18, 0/25, and 0/0 respectively). The only immediate hypersensitivity reactions noted were for patients claiming an allergy to levofloxacin, who received subsequent reexposure to levofloxacin (18.2%; 2/11).

Conclusion

Our data demonstrated a quinolone cross-reactivity frequency of 0%. Despite our relatively small sample size, these results highlighted the likely low risk of experiencing a cross-reaction when exposed to a different quinolone. With further research and larger sample sizes, this low cross-reactivity frequency can offer practitioners clinical guidance for implications of in-class alternatives.