[Multiple drug hypersensitivity in patients with an allergy to antibiotics]

Multiple drug hypersensitivity (MDHS) is defined as confirmed drug hypersensitivity (DHS) to 2 or more drugs that are not chemically related. The objective of our study is to describe the cases of MDHS with antibiotics notified to the regional pharmacovigilance service (SRPV) of Sfax (Tunisia).

Our study is of a descriptive cross-sectional type, focusing on patients who consulted at the SRPV in Sfax during the period between 2013 and 2020 and who presented at least two episodes of DHS occurring at different times (at least one month apart).

In our study, we included 29 patients (18 women and 11 men with a mean age of 59 years) who presented 69 sequential MDHS reactions documented either by a positive re-administration in 29 cases or by allergological exploration in 20 case, or by a highly suggestive clinical history in 20 cases. The frequency of MDHS was 1.13%. The drugs involved in the occurrence of these 69 DHS reactions were antibiotics in 55 cases (80%), antiepileptics in 6 cases (9%), NSAIDs in 4 cases (6%) and other drugs in 4 cases (6%) (one case with allopurinol, one case with strontium ranelate and two cases with gliclazide).

MDHS pose a real problem of therapeutic management. Indeed, these reactions can lead to a difficult choice of drugs with the impossibility of prescribing optimal first-line therapies.