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Tolerance test in patients with multiple drug allergy syndrome
E Nettis1, M C Colanardi, R D Paola
1Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari, Italy. e.nettis@allergy.uniba.it
Abstract:
Multiple Drug Allergy Syndrome (MDAS) is a frequent clinical condition characterized by reactions to more than one different class of antibiotics. Even if some studies have previously reported an increased rate of allergic reactions to drugs in patients with a history of antimicrobials and NSAIDs allergy, risk factors and pathogenesis of MDAS are still object of investigation. Moreover, in these subjects it is often difficult to prescribe a safe alternative antibiotic without a tolerance test. In this study we carried out 504 tests in 460 patients with a history of immediate adverse reactions to antibiotics. From the analysis of our results it emerges that risk factors for MDAS are female sex and intolerance to NSAIDs. Risk factors for positive tolerance test are male sex, intolerance to NSAIDs and a history of MDAS, respectively. In conclusion, it seems that tolerance test may represent a valid approach to detect a safe antibiotic in these patients.
Insights
Multiple Drug Allergy Syndrome (MDAS) involves reactions to various antibiotics. This study identified female sex and NSAID intolerance as key risk factors for MDAS, suggesting tolerance tests can find safe alternatives.
Area of Science:
- Clinical immunology
- Pharmacology
- Allergology
Background:
- Multiple Drug Allergy Syndrome (MDAS) is common, causing reactions to diverse antibiotics.
- Risk factors and pathogenesis of MDAS remain under investigation.
- Identifying safe antibiotic alternatives for MDAS patients is challenging without tolerance testing.
Purpose of the Study:
- To investigate risk factors for MDAS.
- To identify predictors of a positive antibiotic tolerance test.
- To evaluate the utility of tolerance testing in MDAS patients.
Main Methods:
- Conducted 504 tolerance tests in 460 patients with immediate adverse reactions to antibiotics.
- Analyzed patient history, including drug allergies and non-steroidal anti-inflammatory drug (NSAID) intolerance.
Main Results:
- Female sex and NSAID intolerance were identified as risk factors for MDAS.
- Male sex, NSAID intolerance, and a history of MDAS predicted a positive tolerance test.
- Tolerance testing successfully identified safe antibiotic alternatives for many patients.
Conclusions:
- Female sex and NSAID intolerance are significant risk factors for developing MDAS.
- Tolerance testing is a valuable tool for determining safe antibiotic options in patients with MDAS.
- Further research into MDAS pathogenesis and risk stratification is warranted.