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Adverse cutaneous reactions due to macrolides
J M Igea1, S Quirce, B de la Hoz
1Servicio de Alergia, Hospital Ramon y Cajal, Carretera de Colmenar, Madrid, Spain.
Abstract:
Macrolides, which are widely prescribed and seldom produce hypersensitivity reactions, are considered to be safe drugs. We present five patients with generalized skin reactions due to erythromycin and/or spiramycin, proved by oral challenge tests. One patient showed reactions to both erythromycin and spiramycin. All skin prick and patch tests and histamine release tests with both macrolides were negative.
Insights
Macrolide antibiotics like erythromycin are generally safe, but this study found five patients experienced severe skin reactions. Oral challenge tests confirmed these hypersensitivity reactions, even when standard allergy tests were negative.
Area of Science:
- Pharmacology
- Clinical Allergy and Immunology
- Dermatology
Background:
- Macrolides, including erythromycin and spiramycin, are commonly prescribed antibiotics.
- These drugs are generally considered safe with a low incidence of hypersensitivity reactions.
Observation:
- This case series details five patients who developed generalized skin reactions.
- The reactions were associated with the use of erythromycin and/or spiramycin.
Findings:
- Oral challenge tests confirmed hypersensitivity to macrolides in all five patients.
- One patient exhibited reactions to both erythromycin and spiramycin.
- Standard allergy tests, including skin prick, patch, and histamine release tests, were negative for both macrolides.
Implications:
- This study highlights the potential for severe, unpredicted hypersensitivity reactions to macrolides.
- Negative results in standard allergy tests do not exclude macrolide hypersensitivity.
- Further investigation into diagnostic methods for macrolide allergy is warranted.