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Clinical presentation and time course in hypersensitivity reactions to β-lactams

  1. P. J. Bousquet1,2,5,
  2. V. Kvedariene1,3,
  3. H.-B. Co-Minh1,
  4. P. Martins4,
  5. M. Rongier2,
  6. B. Arnoux2,
  7. P. Demoly1,2

Article first published online: 6 JUL 2007

DOI: 10.1111/j.1398-9995.2007.01463.x

Issue

Allergy

Allergy

Volume 62, Issue 8, pages 872–876, August 2007

Additional Information

How to Cite

Bousquet, P. J., Kvedariene, V., Co-Minh, H.-B., Martins, P., Rongier, M., Arnoux, B. and Demoly, P. (2007), Clinical presentation and time course in hypersensitivity reactions to β-lactams. Allergy, 62: 872–876. doi: 10.1111/j.1398-9995.2007.01463.x

Author Information

  1. 1

    Exploration des Allergies, Service des Maladies Respiratoires, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier

  2. 2

    INSERM U454-IFR3, Hôpital Arnaud de Villeneuve, Montpellier, France

  3. 3

    Vilnius University Hospital Santariskiu klinikos, Vilnius, Lithuania

  4. 4

    Immunoallergy Department, Hospital Dona Estefania, Lisboa, Portugal

  5. 5

    Département de l’Information Médicale, GHU Caremeau, Place du professeur Robert Debré, CHU Nîmes, Nîmes, France

*Philippe Jean Bousquet Exploration des Allergies Hôpital Arnaud de Villeneuve University Hospital of Montpellier 34295 Montpellier Cedex 5 France

Publication History

  1. Issue published online: 6 JUL 2007
  2. Article first published online: 6 JUL 2007
  3. Accepted for publication 11 May 2007

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Keywords:

  • drug allergy and hypersensitivity database;
  • drug hypersensitivity;
  • immediate reactions

Background:  β-lactam hypersensitivity reactions are classified as immediate or nonimmediate. Diagnosis is usually based upon skin tests and provocation challenges.

Objective:  The time course of the reactions in proven β-lactam hypersensitivities was studied and then correlated with the symptoms to determine the relationship between the clinical presentations and the time course.

Method:  All of the patients who consulted between 1996 and 2004 for a suspected β-lactam hypersensitivity reaction were studied. Two hundred and ten patients with a proven hypersensitivity reaction diagnosed according to the European Network on Drug Allergy were included in the present study.

Results:  Of the patients, 36.7% had urticaria as a single symptom, 19.1% anaphylaxis without shock, 17.6% anaphylactic shock and 19.1% maculopapular exanthema. Anaphylactic shock and anaphylaxis mostly occurred within 1 h after drug administration. Exanthema mainly occurred after 24 h. Urticaria as a single symptom occurred at any time. A firm diagnosis was determined using immediate-reading skin prick (10.0%) and intradermal tests (38.1%), late-reading skin tests (19.1%) or provocation tests (32.9%).

Conclusion and clinical implication:  Depending on the time course of the reaction, three clinical groups were identified: anaphylaxis and anaphylactic shock (immediate reaction); maculopapular exanthema (late reaction) as well as urticaria (immediate and late reaction).

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