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Clinical & Experimental Allergy

Bronchial asthma due to spiramycin and adipic acid

Authors

  • G. MOSCATO,

    Corresponding author
    1. Fondazione Clinica del Lavoro. Istituto di Medicina del Lavoro dell' Universita degli Studi di Pavia, Italy
      Dr G. Moscato, Istituto di Medicina del Lavoro. Via Boezio 24, 27100 Pavia. Italy
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  • L. NALDI,

    1. Fondazione Clinica del Lavoro. Istituto di Medicina del Lavoro dell' Universita degli Studi di Pavia, Italy
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  • F. CANDURA

    1. Fondazione Clinica del Lavoro. Istituto di Medicina del Lavoro dell' Universita degli Studi di Pavia, Italy
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Dr G. Moscato, Istituto di Medicina del Lavoro. Via Boezio 24, 27100 Pavia. Italy

Summary

Two cases of bronchial asthma due to spiramycin in workers of a pharmaceutical factory are reported. The subjects complained of cough, breathlessness and symptoms of asthma at work when coming into contact with spiramycin's powder. The symptoms cleared when away from work for more than 3 or 4 days.

Inhalation challenge tests by aerosolization of solutions of spiramycin reproduced asthmatic reactions dual in type in both patients, the immediate component of the response has not been previously described for this antibiotic.

Furthermore, one of the patients developed an immediate asthmatic reaction also after inhalation of a solution of adipic acid, and additive to bind spiramycin and diminish its irritant action. The reaction was obtained at a non-irritant concentration of the acid, was reproducible and inhibited by previous administration of sodium cromoglycate: this finding and the failure to elicit the reaction in the other patient suggest a hypersensitivity reaction to this substance.

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