D1.379 - Six-year data evaluating the results of skin tests and provocation tests with quinolones in patients with a history of quinolone allergy

Quinolones frequently cause hypersensitivity reactions, and assessment methods are not standardized. This study aimed to evaluate the diagnostic utility of skin tests and controlled oral provocation tests in patients with a history of quinolone-induced hypersensitivity reactions.

Adult patients evaluated for quinolone allergy over the last six years were retrospectively reviewed. Data included reaction type, culprit drug, comorbidities, and results of skin and oral provocation tests. Skin prick, intradermal, and patch tests were performed, followed by single-blind, placebo-controlled oral provocation in patients with negative tests.

Thirteen patients were included (median age 62.2 years; 8 females). Immediate reactions occurred in 10 patients, including 4 cases of anaphylaxis, while 3 patients experienced delayed reactions. Skin tests with the culprit quinolone were positive in all tested patients, whereas skin and patch tests with alternative quinolones were negative. Oral provocation tests confirmed that every patient tolerated at least one alternative quinolone, regardless of the culprit agent. These findings demonstrate that a structured approach combining skin testing and controlled drug provocation can safely identify tolerable alternatives in patients with quinolone hypersensitivity.

Combined use of skin testing and controlled oral provocation is a safe and reliable approach for individualized evaluation of quinolone hypersensitivity. This strategy enables identification of tolerable alternative quinolones even in patients with previous severe reactions.