| Work up of patients with history of beta-lactam hypersensitivity. | |
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MedLine Citation:
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PMID: 19775797 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Beta-lactam antibiotics are the most frequent cause of antibiotic hypersensitivity reactions. The study of all cases of suspected beta-lactam hypersensitivity is highly important, to avoid the use of less efficient or more expensive alternatives, for fear of a reaction. MATERIALS AND METHODS: Sixty-seven consecutive patients with suspected beta-lactam hypersensitivity reactions were studied. Skin prick tests (SPT), intradermal tests (IDT) and specific IgE determination were performed. In non-immediate reactions, epicutaneous testing was also done. If all were negative, a drug challenge was performed. RESULTS: Sixty-seven patients (54 female symbol), with a mean age + or - SD of 36.6 + or -19.3 years (4-78 years) were studied. The self-reported antibiotics were amoxicillin and amoxicillin/clavulanic acid in 30 (45%), penicillin in 24 (36%), cephalosporins in 11 (16%) and flucloxacillin in 2 (3%). SPT and IDT were positive in 6 patients (9%) and specific IgE in 11 (16%). Only one patient had both positive specific IgE and skin tests. Of the remaining 51 cases, 33 underwent a drug challenge with the culprit antibiotic, with a positive reaction in 2 (6%). In all positive cases and when a drug challenge with the suspected antibiotic was not indicated, a challenge with an alternative drug was done, all with negative results. CONCLUSIONS: Of the 67 studied cases with history of beta-lactam hypersensitivity reactions, 18 (27%) were confirmed after testing. A combination of skin testing, specific IgE determination and drug challenge is necessary since none has sufficient sensitivity to be used alone. |
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Authors:
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R Silva; L Cruz; C Botelho; S Cadinha; E Castro; J Rodrigues; M G Castel-Branco |
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Publication Detail:
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Type: Journal Article Date: 2009-09-23 |
Journal Detail:
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Title: Allergologia et immunopathologia Volume: 37 ISSN: 0301-0546 ISO Abbreviation: Allergol Immunopathol (Madr) Publication Date: 2009 Jul-Aug |
Date Detail:
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Created Date: 2009-10-13 Completed Date: 2010-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370073 Medline TA: Allergol Immunopathol (Madr) Country: Spain |
Other Details:
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Languages: eng Pagination: 193-7 Citation Subset: IM |
Affiliation:
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Allergy and Clinical Immunology Division, Hospital S. Jo??o, EPE - Porto, Portugal. rmcsilva@portugalmail.pt |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Allergens / immunology Anti-Bacterial Agents / immunology* Child Child, Preschool Drug Hypersensitivity / immunology* Female Humans Immunoglobulin E / blood Male Middle Aged Skin Tests Young Adult beta-Lactams / immunology* |
| Chemical | |
Reg. No./Substance:
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0/Allergens; 0/Anti-Bacterial Agents; 0/beta-Lactams; 37341-29-0/Immunoglobulin E |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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