Table 1.
Characteristics of patients who underwent fluoroquinolone intradermal testing and/or selective fluoroquinolone oral challenge
| Total N (% total) or Median [IQR] | |
|---|---|
| Total no. of patients | 163 |
| Age | 61 [50, 70] |
| Time since reaction in years (**n=107, with n=56 missing) | 8 [1, 16] |
| Sex | |
| Female | 128 (78.5) |
| Male | 35 (21.5) |
| Race | |
| White | 145 (89.0) |
| Unknown | 11 (6.7) |
| Black | 6 (3.6) |
| Other | 1 (0.7) |
| Index reaction history | |
| Immediate symptoms (< 1 hour) | 40 (24.5) |
| Mild to moderate exanthem | 15 |
| Urticaria | 15 |
| Angioedema | 11 |
| Shortness of breath | 10 |
| Hypotension | 3 |
| Anaphylaxis | 16a |
| Immediate-type symptoms (1 to 36 hours) | 96 (58.9) |
| Mild to moderate exanthem | 37 |
| Urticaria | 29 |
| Angioedema | 20 |
| Shortness of breath | 13 |
| Hypotension | 2 |
| Anaphylaxis | 15a |
| Non-severe delayed symptoms | 22 (13.5) |
| Unknown | 5 (3.1) |
| Indication for Consult | |
| Multi-drug allergy | 137 (84.0) |
| Anticipated need for treatment and/or prophylaxis | 21 (12.9) |
| Infection without other options | 5 (3.1) |
| Total no. drug allergy labels | 7 [5, 11] |
| No. of antibiotic allergy labels | 5 [3, 7] |
| Penicillin allergy | 127 (77.9) |
| Underwent testing | 116 |
| Label removed | 116 |
| Subsequently treated after removal | 28 |
| Label not removed | 0 |
| Cephalosporin allergy | 94 (57.7) |
| Underwent testing | 60 |
| Label removed or revisedb | 59 |
| Subsequently treated after removal | 16 |
| Label not removed | 1 |
| Sulfa antibiotic allergy | 101 (61.9) |
| Underwent testing | 45 |
| Label removed | 44 |
| Subsequently treated after removal | 7 |
| Label not removed | 1 |
| History of allergy to a drug with an implicated non-IgE mechanism? | |
| Yes | 84 (51.5) |
| Opioid | 62 |
| Radiocontrast | 27 |
| Vancomycin | 21 |
| Neuromuscular blocking agent | 1 |
| No | 79 (48.5) |
| Co-morbidities | |
| Hematologic or oncologic malignancy | 53 |
| Diabetes | 41 |
| Recurrent sinusitis | 41 |
| Recurrent UTI | 27 |
| CVID | 8 |
| Cystic fibrosis | 4 |
| MRSA | 4 |
| Pre-solid organ or bone marrow transplant | 4 |
| Solid organ transplant | 4 |
| HIV | 3 |
| Bone marrow transplant | 1 |
| Nature of initial label | |
| Ciprofloxacin-only | 58 (35.6) |
| Levofloxacin-only | 53 (32.5) |
| Moxifloxacin-only | 13 (8.0) |
| Multiple fluoroquinolones | 39 (23.9) |
| Ciprofloxacin label | 33 |
| Levofloxacin label | 36 |
| Moxifloxacin label | 6 |
| Type of challenge (selected/dependent upon index reaction history) | |
| Ciprofloxacin | 50 |
| Levofloxacin | 33 |
| Moxifloxacin | 2 |
a
Either anaphylaxis or multisystem involvement compatible with anaphylaxis but not clearly defined as such on chart review
b
Label may have been revised to demonstrate safety for a non-cross reactive R-side chain cephalosporin rather than removal of index label due to presence of positive skin test to the index cephalosporin