![]() A query tool within the EHR was used to identify potential participants. Data from the electronic health records (EHRs) of all adult patients within the University of Colorado Health (UCHealth) system (inpatient and outpatient) between 1 January 2012 and 1 January 2021 were collected. ![]() This retrospective study was reviewed and approved by the Colorado Multiple Institutional Review Board. The objective of this study is to explore fluoroquinolone cross-reactivity rates by investigating immediate hypersensitivity reactions in patients with a history of a fluoroquinolone allergy and exposure to an alternative fluoroquinolone agent. The cross-reactivity of fluoroquinolones, therefore, has also been inadequately characterized in the available literature.ĭata regarding potential cross-reactivity of fluoroquinolones are derived primarily from small case studies, some of which use unreliable allergy assessment methods. This, coupled with relatively small sample sizes, may contribute to the general paucity of high-quality fluoroquinolone allergy studies. The necessity of challenging patients’ allergic responses to fluoroquinolones with dose administrations entails a degree of risk and discomfort for the patient. The provocation test entails administration of an oral dose of the potentially immunogenic agent. Without a reliable alternative, the validity of patients’ fluoroquinolone allergies is difficult to determine without subjecting them to drug provocation tests. Immunoglobulin E (IgE) tests, basophil activation tests, and other in vitro allergy assessment methods are similarly unreliable. The accuracy of negative skin test results for fluoroquinolone allergy vary from 50% to 75% negative predictive value. ![]() For example, skin testing techniques to assess for penicillin allergy are reliable and have demonstrated a near 99% negative predictive value. However, fluoroquinolone allergy testing has not advanced as much as β-lactam allergy testing. Fluoroquinolones are also second only to β-lactams in frequency of causing hypersensitivity reactions. In the acute care setting, fluoroquinolones are frequently used when transitioning from intravenous (IV) to oral antibiotics as they have been shown to shorten hospital stays while maintaining similar clinical outcomes. Allergy, ciprofloxacin, IgE-mediated, levofloxacin, moxifloxacinįluoroquinolones are commonly prescribed in the acute and ambulatory care settings.
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