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Comparative frequency of patch test reactions to topical antibiotics
S D Morris1, R J G Rycroft, I R White
1St John's Institute of Dermatology, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK. drsm@doctorsnet.co.uk
The British Journal of Dermatology
|June 20, 2002
Summary
Contact sensitization to topical antibiotics like neomycin, clioquinol, and fusidic acid is a concern. Neomycin showed the highest frequency of allergic reactions in patch testing, while fusidic acid allergy remains low.
Area of Science:
- Dermatology
- Allergology
- Pharmacovigilance
Background:
- Topical antibiotics neomycin, clioquinol, and fusidic acid are frequently used in the UK for dermatological conditions.
- Contact sensitization is a known adverse effect of topical antibiotic use.
Purpose of the Study:
- To determine the prevalence of positive patch test reactions to fusidic acid, clioquinol, and neomycin.
- To compare the frequency of allergic reactions to these commonly used topical antibiotics.
Main Methods:
- A prospective study involving 1119 patients attending a contact dermatitis clinic.
- Patients were patch tested with fusidic acid, neomycin, and clioquinol over one year.
- A retrospective review of fusidic acid patch test reactions over 20 years was also conducted.
Main Results:
- Neomycin elicited the highest rate of positive patch tests (3.6%), followed by clioquinol (0.7%) and fusidic acid (0.3%).
- Neomycin allergy was five times more common than clioquinol allergy and ten times more common than fusidic acid allergy.
- Despite increased usage, the frequency of fusidic acid hypersensitivity has decreased since the early 1980s, with stasis dermatitis being the most common associated diagnosis.
Conclusions:
- The frequency of fusidic acid allergy in patients with eczema is low.
- Current data on fusidic acid allergy is comparable to findings from over a decade ago.