CASE REPORT: ANAPHYLAXIS DURING AZITHROMYCIN PROVOCATION

Abstract

Clarithromycin and azithromycin are the most frequently prescribed oral macrolide antibiotics for children. Macrolides are relatively safe antibiotics due to their low allergenicity, but are nevertheless known to cause hypersensitivity reactions. Azithromycin appears to be responsible for severe reactions more often than clarithromycin. The most common reactions are maculopapular exanthems, and macrolide-induced anaphylaxis is exceptionally rare. Skin tests are not enough for the diagnosis of macrolide allergies, and oral provocation tests are necessary for a definite diagnosis. Here, we present a case of anaphylaxis during oral provocation with azithromycin, in which intolerance to amoxicillin- clavulanic acid and clarithromycin have been verified by provocation testing previously.

Keywords

• Anaphylaxis
• azithromycin
• drug allergy
• drug provocation test

OLGU SUNUMU: AZİTROMİSİN PROVOKASYONU ESNASINDA ANAFİLAKSİ

Abstract

Klaritromisin ve azitromisin çocuklarda sık kullanılan oral makrolid antibiyotiklerdir. Makrolidler düşük alerjenitelerinden dolayı nispeten güvenli antibiyotiklerdir yine de hipersensitivite reaksiyonlarına neden olabilecekleri bilinmektedir. Azitromisin, klaritromisine kıyasla daha ağır reaksiyonlar yapabilmektedir. En sık reaksiyon makülopapüler döküntüdür ve makrolidlerle ilişkili anafilaksi son derece nadirdir. Bugüne kadar az sayıda makrolidlerle ilişkili anafilaksi olgusu bildirilmiştir. Makrolid alerjilerinin tanısı için deri testleri yeterli değildir ve kesin tanı için oral provokasyon testi yapılması gerekmektedir. Burada amoksisilin-klavulanik asit ve klaritromisini tolere edemediği provokasyon testi ile gösterilmiş ve oral azitromisin provokasyon testi sırasında anafilaksi gelişen bir vakayı sunduk.

Keywords

• Anafilaksi
• azitromisi
• ilaç alerjisi
• provokasyon testi

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