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Immediate hypersensitivity: 38 case reports Thirty-eight patients experienced immediate hypersensitivity reactions during treatment with ciprofloxacin, moxifloxacin or levofloxacin; these patients were later evaluated as part of a study. Of the 14 men and 24 women, 24 developed hypersensitivity reactions to moxifloxacin, 11 to ciprofloxacin and three to levofloxacin [dosages, routes, indications and duration of treatments to reaction onsets not stated]. Hypersensitivity reactions included anaphylaxis (16 patients), anaphylactoid shock (10) and urticaria (12). Within 12 months of the initial reaction, the twelve patients with urticarial reactions underwent provocation tests with increasing doses of the implicated drugs until the full therapeutic dose was reached or symptoms occurred (maximal dose 200mg for ciprofloxacin and levofloxacin [cumulative dose 505mg], and 150mg for moxifloxacin [cumulative dose 405mg]). Total IgE measurements ranged from 32.25 to 205.25 in all 38 patients. Sepharose radioimmunoassays were positive in 12 patients. Basophil activation tests using wortmannin were positive in 27 patients, confirming an IgE-mediated reaction. One year later, repeat Sepharose radioimmunoassays in those patients with previously positive readings showed decreased reactivity, and had become negative in four cases. Author comment: "[I]mmediate hypersensitivity reactions to quinolones do exist." Aranda A, et al. In vitro evaluation of IgE-mediated hypersensitivity reactions to quinolones. Allergy 66: 247-254, No. 2, Feb 2011. Available from: URL: http:// 803049073 dx.doi.org/10.1111/j.1398-9995.2010.02460.x - Spain

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Reactions 5 Feb 2011 No. 1337