Λεξικό .. antibiotic allergy

Antibiotics are among the most widely and heavily prescribed drugs, but despite this, allergic reactions to most groups of antibiotics are relatively uncommon-especially when compared with the number and frequency of type 1 hypersensitivity responses to the beta-lactams (ie, penicillins, cephalosporins, and, to a lesser extent, carbopenems). Still, there remains a steady flow of reports of allergic reactions to some topically used antibiotics (eg, rifamycin SV and bacitracin). Moreover, aminoglycosides (eg, neomycin and gramicidin) may be implicated more often than previously suspected. Despite advances in our understanding of the structural basis of the allergenicity of beta-lactam antibiotics, the insights have not readily transferred into routine use to improve diagnoses of reactions to individual penicillins and cephalosporins. This remains a challenge in drug allergy, as does the need for further chemical, immunologic, and clinical research on cephalosporin breakdown products and the so-called multiple antibiotic allergy syndrome [1].

Allergic reactions to antibiotics are common in daily clinical allergy practice. Oral drug provocation tests (ODPT) are used to determine safe alternative antibiotics in addition to diagnostic purposes. The triple-double ODPT ((ciprofloxacin + tetracycline + clarithromycin, ciprofloxacin + tetracycline + ampicillin, clarithromycin + tetracycline + clindamycin and clarithromycin + ciprofloxacin + ampicillin) performed with antibiotics in antibiotic/NSAID hypersensitive patients with the purpose of determining a safe alternative antibiotic could be a safe, cost-effective and time-saving alternative to conventional one day one antibiotic ODPT [2].

References

1. Baldo BA, Zhao Z, Pham NH. Antibiotic allergy: immunochemical and clinical considerations. Curr Allergy Asthma Rep. 2008 Mar;8(1):49-55.

2. Karakaya G, Isik SR, Kalyoncu AF. Determining safe antibiotics for drug hypersensitive patients with the alternative method of double-triple test. Allergol Immunopathol (Madr). 2008 Sep-Oct;36(5):264-70.

3. Gelis' Encyclopedic Dictionary of Allergy, Ed. Vellerefontis, Korinthos, Greece