Skin Testing for the Exploration of Immediate and Delayed Hypersensitivity to Fluoroquinolones: Insights From a Real-Life Cohort Study
Bibliographic record
Abstract
Abstract: Background: Fluoroquinolones (FQ) are the second most frequent antibiotics responsible for hypersensitivity reaction (HSR). Data concerning the interest of allergological work-ups are scarce. Objectives: We reported a university center experience of the interest and safety of skin tests (ST) and drug provocation tests (DPT) for the exploration of immediate hypersensitivity reaction (IHR) and delayed HSR (DHR) to FQ. Materials and Methods: This retrospective study included patients tested for at least 1 FQ between 2008 and 2023. The primary outcome was the frequency of positive tests for FQ. Secondary outcomes aimed to characterize results, cross-reactivity, and tolerance of the tests. Results: Among the 113 patients included (32% in IHR, 68% in DHR), the overall test positivity rate was 27% (29% in DHR, 23% in IHR). Negative predictive value was 85% (80% in DHR, 95% in IHR). The most frequently positive ST was the intradermal test (7%). Allergy was more frequently confirmed for ofloxacin (OFX) (38%). Positive tests were more frequent for fixed drug eruption (67%). Cross-reactivity was detected in 15%, involving OFX and LFX or CPX and OFX. DPT was responsible for nonsevere recurrence of initial HSR for 13% of patients who had DPT and recurrence leading to a short hospitalization for 2% of them. 3% of contacted patients experienced a nonsevere recurrence of HSR in real life. Conclusion: This cohort demonstrates the benefit and safety of allergological exploration for FQ allowing subsequent use in 73% of cases.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".