BACKGROUND: Allergic reactions to one or more beta-lactam antibiotic can pose a management problem in patients with cystic fibrosis (CF), and may limit antibiotic choice. METHOD: The aim of this study was to assess the prevalence of allergy to anti-pseudomonal beta-lactam antibiotics in an adult CF centre and to assess variables, which may contribute to the development of allergic reactions. A questionnaire-based interview and a review of medical records were performed. RESULTS: Of the 150 patients, 54 (36%) had allergic reactions to one or more beta-lactam antibiotics and 20 (19%) had allergic reactions to multiple beta-lactam antibiotics. The proportion of patients allergic to specific beta-lactam antibiotics varied from 10% to 26%. Rates of reactions were highest for penicillins and cephalosporins, intermediate for carbepenems and lowest for aztreonam. Of all reactions, 40% occurred within 24 h of the commencement of an individual antibiotic course. Patients with one or more beta-lactam allergic reactions had received greater cumulative exposure (p<0.0001), were older (p=0.016) and had lower lung function (p=0.037) than patients without a history of beta-lactam allergy. Cystic Fibrosis transmembrane regulator (CFTR) status, gender, peripheral blood eosinophil count and total IgE concentrations were not different in patients with allergic reactions. CONCLUSIONS: This study demonstrates that the prevalence of allergic reactions to beta-lactam antibiotics is high in adults with CF. Increasing age; cumulative exposure and decreasing FEV(1) were associated with the development of allergy.
BACKGROUND:Allergic reactions to one or more beta-lactam antibiotic can pose a management problem in patients with cystic fibrosis (CF), and may limit antibiotic choice. METHOD: The aim of this study was to assess the prevalence of allergy to anti-pseudomonal beta-lactam antibiotics in an adult CF centre and to assess variables, which may contribute to the development of allergic reactions. A questionnaire-based interview and a review of medical records were performed. RESULTS: Of the 150 patients, 54 (36%) had allergic reactions to one or more beta-lactam antibiotics and 20 (19%) had allergic reactions to multiple beta-lactam antibiotics. The proportion of patientsallergic to specific beta-lactam antibiotics varied from 10% to 26%. Rates of reactions were highest for penicillins and cephalosporins, intermediate for carbepenems and lowest for aztreonam. Of all reactions, 40% occurred within 24 h of the commencement of an individual antibiotic course. Patients with one or more beta-lactamallergic reactions had received greater cumulative exposure (p<0.0001), were older (p=0.016) and had lower lung function (p=0.037) than patients without a history of beta-lactamallergy. Cystic Fibrosis transmembrane regulator (CFTR) status, gender, peripheral blood eosinophil count and total IgE concentrations were not different in patients with allergic reactions. CONCLUSIONS: This study demonstrates that the prevalence of allergic reactions to beta-lactam antibiotics is high in adults with CF. Increasing age; cumulative exposure and decreasing FEV(1) were associated with the development of allergy.
Authors: Sabah El-Ghaiesh; Manal M Monshi; Paul Whitaker; Rosalind Jenkins; Xiaoli Meng; John Farrell; Ayman Elsheikh; Daniel Peckham; Neil French; Munir Pirmohamed; B Kevin Park; Dean J Naisbitt Journal: J Pharmacol Exp Ther Date: 2012-02-27 Impact factor: 4.030
Authors: Henry J Legere; Ross I Palis; Tito Rodriguez Bouza; Ahmet Z Uluer; Mariana C Castells Journal: J Cyst Fibros Date: 2009-09-08 Impact factor: 5.482
Authors: Paul Whitaker; Xiaoli Meng; Sidonie N Lavergne; Sabah El-Ghaiesh; Manal Monshi; Caroline Earnshaw; Daniel Peckham; Jimmy Gooi; Steve Conway; Munir Pirmohamed; Rosalind E Jenkins; Dean J Naisbitt; B Kevin Park Journal: J Immunol Date: 2011-05-23 Impact factor: 5.422