Rational Approach to the Patient with Antibiotic Allergy

Year 2019, Volume: 11 Issue: 2, 48 - 54, 07.03.2019

Dr. Öğr.üyesi Pınar Gökmirza Özdemir

Abstract

Abstract

Drug reactions can be seen in childhood as well as in adults.  Drug reactions with immune mechanisms constitute 6-10% of all drug reactions. Hypersensitivity reactions in children are most commonly related with antibiotics. Here in; we present acase with streptococcal tonsillopharyngitis and  history of penicillin allergy, to explain the rational approach to the patient with antibiotic allergy.

Keywords

Antibiotic allergy, drug allergy tests, desensitization

Antibiyotik Alerjisi Olan Hastaya Akılcı Yaklaşım

Abstract

Öz

İlaç reaksiyonları erişkinlerde olduğu gibi çocukluk çağında da görülebilmektedir.  İmmün mekanizmalar ile oluşan ilaç reaksiyonları tüm reaksiyonların %6-10’unuoluşturmaktadır.  Çocuklarda görülen aşırı duyarlılık reaksiyonları en sık olarak antibiyotik kullanımı ile ilişkilidir. Bu yazıda streptokoksik tonsillofarenjit tanısı alanve öyküsünde penisilin alerjisi olan bir olgu sunularak antibiyotik alerjisi olan hastaya akılcı yaklaşım basamaklarının anlatılması amaçlanmıştır.

Keywords

Antibiyotik alerjisi, ilaç alerjisitestleri, , desensitizasyon

References

• Kaynaklar 1-Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G,Martin JM, Van Beneden C; Infectious Diseases Society of America.Clinical practice guideline for the diagnosis and management of gro-up A streptococcal pharyngitis: 2012 update by the Infectious Disea-ses Society of America. Clin Infect Dis. 2012 Nov 15;55(10):e86-102. 2-Gerber MA, Baltimore RS, Eaton CB, Gewitz M, Rowley AH, ShulmanST, Taubert KA. Prevention of rheumatic fever and diagnosis and treat-ment of acute Streptococcal pharyngitis: a scientific statement from theAmerican Heart Association Rheumatic Fever, Endocarditis, and Kawa-saki Disease Committee of the Council on Cardiovascular Disease inthe Young, the Interdisciplinary Council on Functional Genomics andTranslational Biology, and the Interdisciplinary Council on Quality ofCare and Outcomes Research: endorsed by the American Academy ofPediatrics. Circulation. 2009 Mar 24;119(11):1541-51 3-ÇelikGE. İlaç Aşırı Duyarlılık Reaksiyonlarına Yaklaşım Ulusal Rehber.1. Baskı. Ankara: Bilimsel Tıp Yayınevi, 2014;40-95 4-Çelik G, Pichler WJ, Adkinson NF. Drug Allergy. In: Adkinson NF,Bochner BS, Busse WW, Holgate ST, Lemanske RF, Simons FER(eds.). Allergy Principles and Practice. 7th ed. Philadelphia: Mosby-Elsevier Inc; 2009.p.1205-1226. 5-Riedl M, Casillas AM. Adverse drug reactions: types and treatmentoptions. Am Fam Physician 2003;9:1781-90. 6-Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Green-berger PA, Khan DA, Lang DM, Park HS, Pichler W, Sanchez-BorgesM, Shiohara T, Thong BY. International Consensus on drug allergy.Allergy. 2014 Apr;69(4):420-37 7-Cantani A. Allergic and pseudoallergic reactions to drugs. Cantani A(Ed). In: Pediatric Allergy, Asthma and Immunology. Berlin: Springer-Verlag; 2008: 1147-203. 8-Impicciatore P, Choonara I, Clarkson A, Provasi D, Pandolfini C, Bo-nati M. Incidence of adverse drug reactions in pediatric in/out pati-ents: a systematic review and meta-analysis of prospective studies. BrJ Clin Pharmacol 2001;52:77-83. 9-Clavenna A, Bonati M. Adverse drug reactions in childhood: a review ofprospective studies and safety alerts. Arch Dis Child 2009;94:724–728. 10-Aagaard L, Christensen A and Hansen E H (2010), Information aboutadverse drug reactions reported in children: a qualitative review of em-pirical studies. British Journal of Clinical Pharmacology, 70: 481–491. 11-Cohen AL, Budnitz DS, Weidenbach KN, Jernigan DB, Schroeder TJ,Shehab N, Pollock DA. National Surveillance of Emergency Depart-ment Visits for Outpatient Adverse Drug Events in Children and Ado-lescents .J Pediatr 2008;152:416-21. 12-Lieber NSR, Riberio E. Adverse drug reactions leading children to theEmergency Department. Rev Bras Epidemiol 2012;15(2):265-74. 13-Solensky R. Hypersensitivity reactions to beta-lactam antibiotics. ClinRev Allergy Immunol. 2003 Jun;24(3):201-20. 14-Cetinkaya F, Cag Y. Penicillin sensitivity among children without apositive history for penicillin allergy. Pediatr Allergy Immunol. 2004Jun;15(3):278-80 15-Büyüköztürk S. İlaç Alerjileri. İstanbul: Nobel Tıp Kitabevleri; 2004:20-7. 16-Segal AR, Doherty KM, Leggott J, Zlotoff B. Cutaneous reactions todrugs in children. Pediatrics 2007;120;1082-96. 17-Gruchalla R. Understanding drug allergies. J Allergy Clin Immunol2000;105:637-44. 18-Gruchalla RS. Clinical assessment of drug-induced disease. Lancet2000;356:1505-11 19-Nagao-Dias AT, Barros-Nunes P, Celho HLL, Sole D. Allergic drugreactions. J Pediatr (Rio J) 2004;80(4):259-66. 20-Van Driel ML, De Sutter AI, Habraken H, Thorning S, Christiaens T.Different antibiotic treatments for group A streptococcal pharyngitis.Cochrane Database Syst Rev. 2016 Sep 11;9:CD004406. 21-De Muri GP, Sterkel AK, Kubica PA, Duster MN, Reed KD, Wald ER.Macrolide and Clindamycin Resistance in Group a Streptococci Isola-ted From Children With Pharyngitis Pediatr Infect Dis J. 2017Mar;36(3):342-344. 22-Sullivan TJ. Antigen-specific desensitization of patients allergic topenicillin. J Allergy Clin Immunol. 1982 Jun;69(6):500-8 23-Macy E, Schatz M, Lin CK, Poon KY. The falling rate of positive penicillinskin tests from 1995 to 2007. Perm J 2009; 13:12–8. 24-Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reac-tions in hospitalized patients: a meta-analysis of prospective studies.JAMA 1998;279:1200-5 25-Edwards IR, Aronson JK. Adverse drug reactions: definitions, classificati-on, diagnosis, management, surveillance. Lancet 2000;356:1255-60. 26-Lee A, Bateman N, Edwards C, Smith JM, Rawlins MD. Reporting ofadverse drug reactions by hospital pharmacists: pilot scheme. BMJ1997;315:520–23.