Criteria for intradermal skin testing and oral challenge in patients labeled as fluoroquinolone allergic

Abstract

Allergy to fluoroquinolones (FQs) is the most frequently reported non–beta-lactam antibiotic allergy.1 The basic FQ structure is a bicyclic skeleton and can be classified by generation, with later generations correlating with broader gram-positive and anaerobic antimicrobial spectrum in particular.1 Interpretation of hypersensitivity reactions to FQs is likely complicated by non–IgE-mediated reactions because all FQs are small-molecule ligands for the mast cell G-protein–coupled receptor MRGPRX2 and have been shown to lead to direct mast cell activation in both in vitro models with the human MRGPRX2 receptor and murine models.