Long-term reproducibility of positive patch test reactions in patients with non-immediate cutaneous adverse drug reactions to antibiotics.

Abstract

BACKGROUND:

As in contact allergy, T cell-mediated hypersensitivity in non-immediate (NI) cutaneous adverse drug reactions (CADRs) to antibiotics is considered to be lifelong, but, in this setting, patch tests have rarely been repeated after long time intervals.

OBJECTIVE:

To evaluate the long-term reproducibility of positive patch test reactions to antibiotics in patients with NI CADRs.

METHODS:

Fifty-six patients with NI CADRs to antibiotics who had relevant positive reactions during patch testing were invited to repeat patch tests with a similar antibiotic series 2-15 years thereafter.

RESULTS:

Twenty patients were included (9 males and 11 females; mean age 54.6 years): 18 with maculopapular exanthema, 1 with drug hypersensitivity syndrome, and 1 with acute generalized exanthematous pustulosis. Results were reproducible in 17 of 20 patients after a mean interval of 6.0 years (range 2-14.7 years). Concerning β-lactams, 7 of 8 patients remained positive for aminopenicillins, 4 of 4 for isoxazolyl penicillins, and 1 for cefoxitin. Patch test results were also reproducible for clindamycin in 5 of 7 patients, for vancomycin in 1 patient, and for spiramycin in 1 patient. Reproducibility was not affected by the time interval between tests, sex, or age at testing.

CONCLUSIONS:

In the context of NI CADRs, we showed high reproducibility of positive patch test reactions to various antibiotics, even after several years.

• Authors: André Pinho, Ana Marta, Inês Coutinho, Margarida Gonçalo
• Journal: Contact dermatitis (Contact Dermatitis) Vol. 76 Issue 4 Pg. 204-209 (Apr 2017) ISSN: 1600-0536 [Electronic] England
• PMID: 27910104 (Publication Type: Journal Article)
• Copyright: © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Anti-Bacterial Agents

Topics

• Adult
• Anti-Bacterial Agents (adverse effects)
• Drug Hypersensitivity (diagnosis)
• Female
• Humans
• Hypersensitivity, Delayed (chemically induced, diagnosis)
• Male
• Middle Aged
• Patch Tests (methods)
• Reproducibility of Results