Antibiotic hypersensitivity reactions and approaches to desensitization

Clin Infect Dis. 2014 Apr;58(8):1140-8. doi: 10.1093/cid/cit949. Epub 2013 Dec 23.

Abstract

Before initiating antibiotic therapy, drug hypersensitivity is an important consideration, and a common strategy is to avoid giving patients medications when a high likelihood of severe reactions exists. With an increase in antibiotic resistance and a decrease in novel antibiotics, there is greater pressure to consider antibiotics in patients with a history of adverse reactions. The major concerns include IgE-mediated, or type I, reactions, anaphylaxis, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Some antibiotics with similar characteristics, such as cephalosporins and penicillins, may be given safely to patients with a certain allergy profile. There is still greater concern when considering antibiotics for patients with reported allergy. Desensitization is a strategy to safely induce drug tolerance to a specific drug to limit the possibility of a type I reaction.

Keywords: desensitization; drug allergy; hypersensitivity; vancomycin; β-lactam.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / immunology*
  • Anti-Bacterial Agents / therapeutic use*
  • Desensitization, Immunologic / methods*
  • Drug Hypersensitivity / therapy*
  • Humans

Substances

  • Anti-Bacterial Agents