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

I. Mota, Â. Gaspar, M. Chambel, S. Piedade, M. Morais-Almeida
Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
Eur Ann Allergy Clin Immunol 2016;48(6):212-219

ABSTRACT
Background: Beta-lactams antibiotics (BL) are the most frequent elicitors of allergic drug reactions. The aim of our
study was to characterize the patients referred with suspected hypersensitivity (HS) to BL. Methods: Over a three-
year period (2011-2013), a total of 234 adult and paediatric patients (pts) with suspected HS to BL were investigated
according to the European Network for Drug Allergy guidelines. Results: HS to BL was confirmed in 43 pts (18%),
without differences between adult and paediatric pts; anaphylaxis was reported by 20 pts. Diagnosis was ascertained
by: serum-specific IgE antibodies in 5 pts (12%), skin prick tests in 5 (12%), intradermal tests in 25 (58%), 3 with
delayed reading, and the remaining 8 (18%) by drug provocation tests. Penicillins / derivatives were the culprit drugs
in 39 pts, mainly amoxicillin, and cephalosporins in 4. Conclusions. In most of these patients with suspected HS to
BL, allergological work-up was negative and HS was excluded. One fourth of confirmed cases had a plausible non-
IgE mediated mechanism.
Keywords: Adults, beta-lactams, drug allergy, children, skin tests.

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