Quinolones-induced hypersensitivity reactions

Quinolones are broad spectrum antibiotics that are intensively used and can induce immediate- and delayed-type hypersensitivity reactions, either IgE or T-cell mediated, in about 2-3% of treated patients. Objective: To better understand how T cells interact with quinolones to produce the hypersensitivity and to describe the possible prevention of the reactions. Methods: We search in PubMed for quinolones and adverse reactions naming each one of the therapeutics in use and the possible hypersensitivity reactions e.g., anaphylaxis, drug-induced delayed reactions, and hypersensitivity syndrome reactions. We also performed a search on organ-specific hypersensitivity reactions including cutaneous reactions, hepatic reactions, and renal reactions. Results: Our data show that T cells are involved in delayed immune reactions to quinolones and that cross-reactivity among the different quinolones is frequent. The predictive tests for quinolone-induced hypersensitivity should be used in patients before they are given the medication. Conclusions: Early identification of the mechanism of toxicity, quantitative assessment using laboratory tests, analysis of risk factors for patient susceptibility to the quinolones, and possible drug-drug interactions may lead to appropriate patient selection for therapy, monitoring the injury early and discontinuation of the therapeutic agent.