Three cases of immediate hypersensitivity to quinolones: Analysis of cross-reactivity between quinolones

Abstract

We report three cases of immediate hypersensitivity to quinolones. We divided quinolones into two groups: those consisting of a bicyclic or a tricyclic ring structure. The sensitizing and crossreactivity drugs were as follows: ciprofloxacin and moxifloxacin with a bicyclic ring structure (Case 1), levofloxacin and pazufloxacin with a tricyclic ring structure (Case 2), and levofloxacin and ofloxacin containing its optical isomer (Case 3). It is likely that antigenic determinants are a cyclopropyl group in position 1 of a bicyclic ring structure and a pyridobenzoxazine ring of a tricyclic ring structure. Our data indicate that cross-reactivity of quinolones tends to occur within groups and may not occur between different groups.