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Related Experiment Video

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Hypersensitivity to beta-lactam antibiotics: a three-year study.

I Mota1, Â Gaspar1, M Chambel1

  • 1Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal.

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|November 18, 2016
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Summary

Most patients with suspected beta-lactam hypersensitivity (HS) had negative allergy tests. Confirmed beta-lactam HS cases often involved non-IgE mechanisms, particularly in penicillin-allergic individuals.

Keywords:
adultsbeta-lactamschildrendrug allergyskin tests

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Area of Science:

  • Clinical Immunology
  • Pharmacology
  • Allergy and Immunology

Background:

  • Beta-lactam (BL) antibiotics are common causes of allergic drug reactions.
  • Characterizing patients with suspected BL hypersensitivity (HS) is crucial for accurate diagnosis.

Purpose of the Study:

  • To investigate and characterize adult and pediatric patients referred for suspected hypersensitivity to beta-lactam antibiotics.
  • To determine the diagnostic yield of various allergological work-up methods for BL hypersensitivity.

Main Methods:

  • A cohort of 234 patients with suspected BL HS were investigated over three years (2011-2013).
  • Diagnostic methods included serum-specific IgE, skin prick tests, intradermal tests, and drug provocation tests.
  • European Network for Drug Allergy guidelines were followed for patient investigation.

Main Results:

  • Hypersensitivity to BL was confirmed in 18% of patients (43/234), with no significant difference between adults and children.
  • Anaphylaxis was reported in 20 patients.
  • Penicillins/derivatives were implicated in 39 cases, primarily amoxicillin; cephalosporins in 4 cases.

Conclusions:

  • The majority of patients with suspected BL HS showed negative allergological work-up, leading to exclusion of hypersensitivity.
  • Approximately 25% of confirmed BL hypersensitivity cases exhibited plausible non-IgE mediated mechanisms.