Abstract
Quinolones are the second most common antibiotic class that may induce IgE and non-IgE-mediated immediate hypersensitivity reactions. The prevalence of true quinolone allergy still remains unknown, but its incidence has increased in recent years, probably due to the extensive utilization of this antibiotic class and the introduction of moxifloxacin. Quinolones may also induce nonallergic reactions through the MRGPRX2 receptor. The diagnosis of hypersensitivity reactions to quinolones is complex, since clinical history is often doubtful, skin tests can induce false-positive results, and in vitro tests are not well validated. Therefore, in many cases, the only way to confirm or rule out the diagnosis is drug provocation test, a procedure that carries some risks. Quinolones present a variable degree of cross-reactivity that is undetermined and difficult to predict, and desensitization may be required in patients with no other antibiotic options. This review critically analyzed the existing data on quinolone allergy, highlighting the recent advances in its diagnosis and management. Further studies are needed to increase the knowledge in the field and to improve patients’ care.
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