title: Quinolones-induced hypersensitivity reactions.
abstract: Quinolones are broad spectrum antibiotics that are intensively used and can induce immediate- and delayed-type hypersensitivity reactions, either IgE or T-cell mediated, in about 2-3% of treated patients.
  
  
  OBJECTIVE
  To better understand how T cells interact with quinolones to produce the hypersensitivity and to describe the possible prevention of the reactions.
  
  
  METHODS
  We search in PubMed for quinolones and adverse reactions naming each one of the therapeutics in use and the possible hypersensitivity reactions e.g., anaphylaxis, drug-induced delayed reactions, and hypersensitivity syndrome reactions. We also performed a search on organ-specific hypersensitivity reactions including cutaneous reactions, hepatic reactions, and renal reactions.
  
  
  RESULTS
  Our data show that T cells are involved in delayed immune reactions to quinolones and that cross-reactivity among the different quinolones is frequent. The predictive tests for quinolone-induced hypersensitivity should be used in patients before they are given the medication.
  
  
  CONCLUSIONS
  Early identification of the mechanism of toxicity, quantitative assessment using laboratory tests, analysis of risk factors for patient susceptibility to the quinolones, and possible drug-drug interactions may lead to appropriate patient selection for therapy, monitoring the injury early and discontinuation of the therapeutic agent.
authors.affiliation: In Vitro Drug Safety and Biotechnology, University of Toronto, Canada; Department of Pharmacology and Toxicology, University of Toronto, Canada. Electronic address: manuela.neuman@utoronto.ca.
authors.forename: Manuela G
authors.initials: MG
authors.lastname: Neuman
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, University of Toronto, Canada; Division of Gastroenterology, Sunnybrook Health Science Centre, Toronto, Ontario, Canada.
authors.forename: Lawrence B
authors.initials: LB
authors.lastname: Cohen
authors.affiliation: In Vitro Drug Safety and Biotechnology, University of Toronto, Canada.
authors.forename: Radu M
authors.initials: RM
authors.lastname: Nanau
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000378:metabolism; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000378:metabolism; D004347:Drug Interactions / Q000502:physiology; D006801:Humans; D015363:Quinolones / Q000009:adverse effects* / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D015363:Quinolones
keywords: Drug-induced liver injury; Hypersensitivity syndrome reaction; Immune-mediated drug hypersensitivity reaction; Lymphocyte toxicity assay; Quinolones