Decrease of selective immunoglobulin E response to amoxicillin despite repeated administration of benzylpenicillin and penicillin V
Article first published online: 2 DEC 2005
Clinical & Experimental Allergy
Volume 35, Issue 12, pages 1645–1650, December 2005
How to Cite
Fernandez, T., Torres, M. J., R-Pena, R., Fuentes, M. S., Robles, S., Mayorga, C. and Blanca, M. (2005), Decrease of selective immunoglobulin E response to amoxicillin despite repeated administration of benzylpenicillin and penicillin V. Clinical & Experimental Allergy, 35: 1645–1650. doi: 10.1111/j.1365-2222.2005.02378.x
- Issue published online: 2 DEC 2005
- Article first published online: 2 DEC 2005
- Submitted 16 March 2005; revised 24 August 2005; accepted 20 September 2005
- allergic reactions;
- immediate reactions;
- in vitro tests;
- skin test
Background Subjects with IgE responses to betalactams can develop selective or cross-reactive responses after the administration of penicillin derivatives. After the reaction, however, the hapten induces a boosting phenomenon, which may increase the titre and the affinity of the antibody, with the resulting risk of developing allergic reactions to other penicillins.
Objective To determine in subjects with selective responses to amoxicillin (AX) and good tolerance to benzylpenicillin (BP) and penicillin V (PV) whether the administration of these compounds induced any change in specificity, measured by either skin or in vitro testing, which could predict the appearance of cross-reactivity.
Methods Ten subjects with a selective response to AX were followed-up for 2 years with the periodic administration of penicillin G and V (Group A) and compared with another group composed of 10 persons with identical clinical characteristics but without repeated penicillin administration (Group B). Periodic in vitro and in vivo measurements of specific IgE antibodies were performed at 6-month intervals. Patients were randomized to Group A or B according to their order of inclusion.
Results In both groups, skin test reactivity tended to decrease, and although greater in Group A, the difference was not significant compared with Group B. Median RAST values also decreased over time and showed no differences in the exposed group compared with the controls. One patient in Group A became positive to benzylpenicilloyl (BPO), despite becoming negative to AX.
Conclusion Subjects with selective IgE responses to side-chain-specific determinants seem to become negative, with no influence from subsequent administration of a closely related penicillin.