Tolerability of moxifloxacin in patients with antibiotic hypersensitivity.
BACKGROUND
Allergic reactions to antibiotics are commonly reported in the clinical practice. The treatment of antibiotic hypersensitivity (AH) consists of suggesting to avoid the offending antibiotics and to use safe alternatives after performing oral provocation tests (OPT). Moxifloxacin is a new fluoroquinolone antibacterial agent with a broad spectrum activity. Allergic reactions to moxifloxacin have rarely been described and therefore it could be tolerated by antibiotic allergic subjects.


OBJECTIVE
The aim of this survey was to investigate the tolerability of moxifloxacin in antibiotic intolerant patients.


METHODS
A prospective study was conducted in 20 patients diagnosed with AH at our clinic between 1 January 2003 and 31 December 2003. We performed single blind, one day OPT protocol for moxifloxacin with a total dose of 1000 mg.


RESULTS
The mean age of the patients was 38.05 +/- 14.1 and 17 (85 %) of them were females. There were only two patients with accompanying allergic diseases; one with bronchial asthma and the other with chronic urticaria. The rates of common anamnestic antibiotic hypersensitivities were 50 % with amoxicillin, 40 % with penicillin, 20 % with sulphonamides, respectively. Urticaria (80 %) was the leading reaction appearing after antibiotic ingestion. Seventeen of 20 patients tolerated moxifloxacin at therapeutic doses without any problem. One patient experienced generalized urticaria 4 hours after ingestion of the first dose of the drug, which resolved spontaneously 5 hours after the onset. Another patient experienced tachycardia (heart rate did not exceed beyond 115 per minute) 2.5 hours after ingestion of first dose of the drug, which resolved spontaneously 2 hours after the onset. And a third one developed severe nausea lasting for two hours.


CONCLUSIONS
Given the high incidence of hypersensitivity reactions to beta-lactam antibiotics the use of new fluoroquinolone, moxifloxacin might represent a therapeutic alternative.
Bozkurt
B
B
Department of Chest Diseases, Hacettepe University, School of Medicine, Sihhiye Ankara, Turkey. bubozkur@hacettepe.edu.tr
Karakaya
G
G
Kalyoncu
A F
AF
D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001372:Aza Compounds / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology; D004342:Drug Hypersensitivity / Q000209:etiology*; D004417:Dyspnea / Q000139:chemically induced; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D009325:Nausea / Q000139:chemically induced; D011446:Prospective Studies; D011804:Quinolines / Q000009:adverse effects*; D016037:Single-Blind Method; D013610:Tachycardia / Q000139:chemically induced; D014581:Urticaria / Q000139:chemically induced
D000890:Anti-Infective Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077266:Moxifloxacin