Hypersensitivity and Anaphylactoid Reactions to Ciprofloxacin

Deamer, Robert L.; Prichard, John G.; Loman, Geoffrey J.

doi:10.1177/106002809202600905

Cited by 31 publications

(10 citation statements)

References 15 publications

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“…1 A high frequency of adverse reactions has been found in HIVinfected patients treated with ciprofloxacin. [2][3][4][5] The most frequently described reactions are immediate, suggesting a type I (IgE-mediated) allergic mechanism. Clinical manifestations include pruritus, urticaria, angioedema, and shock.…”

mentioning

confidence: 98%

Detection of specific IgE to quinolones

Manfredi

Severino

Testi

et al. 2004

Journal of Allergy and Clinical Immunology

129

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mentioning

confidence: 98%

Detection of specific IgE to quinolones

Manfredi

Severino

Testi

et al. 2004

Journal of Allergy and Clinical Immunology

129

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“…There are also a number of severe anaphylactic shocks, even one with fatal outcome from ciprofloxacin, in HIV-positive patients [8]. However, to our knowledge, there is no recent study evaluating the influence of risk factors to develop a hypersensitivity to a fluoroquinolone.…”

Section: Immediate Reactionsmentioning

confidence: 96%

Hypersensitivity reactions to fluoroquinolones

Scherer

Bircher

2005

Curr Allergy Asthma Rep

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Fluoroquinolone antibiotics cause immediate and delayed hypersensitivity reactions, and may also affect internal organs and circulating blood cells. The underlying pathomechanisms are only partly understood. The extent of cross-reactivity among different quinolones depends on the type of clinical manifestation and its underlying mechanism. Despite recent advances, reliable diagnostic tests are still lacking. Recent studies have shown quinolone-specific IgE in vitro in more than 50% of patients with immediate-type reactions and a considerable cross-reactivity with related compounds. In maculopapular drug exanthems from ciprofloxacin, specific T-cell clones were identified, and cross-reactivity to related compounds was detected in approximately 50% of the clones. From re-exposure studies in patients with exanthems, cross-reactivity appears to be lower. Cellular tests such as lymphocyte transformation tests are currently not very useful. For prick and intradermal skin tests, widely divergent nonirritant test concentrations have been recommended. Desensitization may be possible in selected patients.

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“…The postmarketing studies of the newer quinolones (temafloxacin, grepafloxacin, trovafloxacin) identified severe adverse effects such as anaphylactoid reactions, hemolytic anemia, QT‐interval prolongation and liver necrosis [33]. The older quinolones—ciprofloxacin, ofloxacin and levofloxacin—have not been associated with these adverse events, except for anecdotal anaphylactoid reactions due to ciprofloxacin reported in the literature [34]. Fluoroquinolones are not recommended for women during pregnancy, lactation or for young children, because of concerns about teratogenesis and cartilage toxicity.…”

Section: Antibiotic Toxicitymentioning

confidence: 99%

Problems associated with potential massive use of antimicrobial agents as prophylaxis or therapy of a bioterrorist attack

Navas

2002

Clinical Microbiology and Infection

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In addition to the direct sanitary damage of a terrorist attack caused by biological weapons, the consequences of the massive stockpiling and consumption of antimicrobial agents in order to treat or prevent the disease under a potential epidemic due to pathogenic bacteria must also be considered. Bacillus anthracis, Francisella tularensis and Yersinia pestis are the bacteria most likely to be used as terrorist weapons. Tetracyclines, quinolones and aminoglycoside are the antibiotics of choice against these microorganisms. The recent terrorist attack with anthrax spores in the USA caused a substantial increase in the sales of ciprofloxacin, as thousands of citizens received antibiotic prophylaxis for either confirmed or suspected exposure to anthrax, and many others stockpiled antibiotic supplies at their homes under a panic scenario. The massive consumption of antimicrobial drugs may lead to the selection of antibiotic resistant strains, and to the appearance of undesirable side effects, such as anaphylaxis or teratogenesis. National health authorities must develop realistic protocols in order to detect, treat and prevent mass casualties caused by biological weapons. An antibiotic stockpile has to be planned and implemented, and home stockpiling of antibiotics must be strongly discouraged.

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Hypersensitivity and Anaphylactoid Reactions to Ciprofloxacin

Abstract: As with trimethoprim/sulfamethoxazole, HIV-infected people treated with ciprofloxacin may be at special risk for hypersensitivity reactions.

Cited by 31 publications

References 15 publications

Detection of specific IgE to quinolones

Detection of specific IgE to quinolones

Hypersensitivity reactions to fluoroquinolones

Problems associated with potential massive use of antimicrobial agents as prophylaxis or therapy of a bioterrorist attack

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