Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042109 (urticaria)
 6,569 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ampicillin is the most commonly prescribed antibiotic in the United States, and causes skin reactions in five to ten percent of patient populations. These reactions are considerably more frequent in patients with a viral illness, infectious mononucleosis, and lymphocytic leukemia. Skin reactions to ampicillin are usually of two types: a maculopapular rash in about two thirds of cases, and urticaria in about one third of cases. There is strong evidence that the maculopapular rash is a benign, nonallergic phenomenon. Patients with the maculopapular ampicillin rash are often incorrectly labeled as allergic to ampicillin/penicillin. Ampicillin can be continued and administered again in the future in these patients, and this kind of skin reaction resolves spontaneously in a few days without sequelae. Skin tests are neither required nor recommended to document the nonallergic basis of the maculopapular ampicillin rash.
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PMID:The ampicillin rash as a diagnostic and management problem: case reports and literature review. 15 Nov 25

A survey was made on workers handling powdered drugs in a pharmaceutical factory. In this factory, two kinds of anti-inflammatory enzyme (bromelain and trypsin), one anti-inflammatory agent (flufenamic acid), one antispasmodic (flopropion) and two kinds of antibiotics (ampicillin and cephalexin) are mainly produced. Twenty four workers were examined by interviews and checked by Cornell Medical Index, and 18 of them complained of respiratory symptoms. These 18 workers were physically examined by skin scratch tests, pulmonary function tests and serum immunological tests. Among 24 workers, 9 handled powdered drugs (A group), 5 handled the same in the past and had already been transferred to other sections for their symptoms (B group), 3 engaged in the process of capsul-filling (C group) and 7 handled several times occasionally during one year (D group). Their average months spent in handling powdered drugs were, in the case of anti-inflammatory enzyme, A group 53.2, B group 66.2, and in the case of antibiotics, 5 workers in A group 24.0, 2 workers in B group 7.0, 3 workers in C group 25.7. Twenty workers complained of symptoms which were mainly irritation of mucosa including the respiratory system and itching of the skin while they were working, and accelerated nasal discharge, urticaria and asthma after working. Group A and group B were higher than group D in the rate of respiratory complaints in C.M.I. (p less than 0.001). Fourteen workers pointed out anti-inflammatory enzyme as a cause of main symptoms, 7 workers flufenamic acid, 3 workers flopropion, 4 workers antibiotics. Three workers who had past history of asthma or articular rheumatism had been transferred to other sections. Of 18 workers who were physically examined, 11 workers showed positive reactions to skin scratch tests with handling drugs. On 8 workers of them, some kinds of drugs which were pointed out as drugs causing main symptoms reacted positively. Numbers of workers with increased immunoglobin values were, IgE 3, IgM 2, IgA 4, IgM 2. Two workers showed decreased FVC and FEV (1.0 sec.) values in pulmonary function tests. The causes of the occupational allergic reaction in this factory are guessed as follows: 1) control of powdered materials was incomplete in the process of production, 2) various kinds of sensitizing drugs were handled by the same workers.
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PMID:[Some experiments on the allergic reaction among workers in a pharmaceutical factory (author's transl)]. 16 Apr 71

35 individuals showing reactions to penicillin of anaphylactic shock, angioedema or urticaria were investigated. Their skin sensitivity was analysed using 16 different penicillin derivatives. In addition, the content of circulating reagins against the penicilloyl structure in the patient's sera were analysed using RAST. 17 of the patients had negative skin reactions and RAST results to all substances tested. The other 18 were skin test-positive to at least one derivative but showed markedly heterogeneous patterns of skin reactivity. 14 had positive reactions against penicilloyl structures accompanied by anti-penicilloyl reagins. Four patients showed doubtful reactions only to penicillin or penicilloate and/or penilloate. These patients also had very low levels of reagins against penicilloyl in their sera. Positive skin test results using monovalent penicillin derivatives such as penicillin, penicilloate, penilloate, penicilloyl amide, penicilloyl-formyl-lysine, penicillamine, which cannot form a multivalent antigen with penicillyol specificity, indicated formation of other derivatives of importance in penicillin allergy, e.g., penicillamine protein conjugates. Three patients showed skin reactions to ampicillin polymer and two to benzyl-penicillin polymer. The skin tests performed with the penicillin derivatives used do not seem to give more information on the sensitivity of the patients than does the RAST using penicilloyl structures.
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PMID:Antibody reactivity in penicillin-sensitive patients determinated with different penicillin derivatives. 40 32

The reliability of skin testing in the diagnosis of penicillin allergy was studied in 86 adults and 167 children with a history of possible hypersensitivity reactions to penicillin. Skin testing was done with the major antigenic determinant of benzylpenicillin and minor determinants of benzylpenicillin, ampicillin, cloxacillin, methicillin and cephalothin. The overall frequency of positive skin reactions was 11.5%. Among the patients with positive skin reactions about half had a history of immediate or accelerated reactions to penicillins, but 2 of 11 adults and 50% of the children in this group had a history of maculopapular rash of delayed onset. There was a low frequency of positive skin reactions when there was a long interval between the times of clinical reaction and skin testing. Of 169 patients reacting negatively to skin testing who received a specific drug challenge only 2 manifested mild urticaria; this indicates the reliability of the skin tests in predicting penicillin allergy. The major and minor determinants of benzylpenicillin were the most useful reagents. One fifth of the patients with penicillin hypersensitivity would have been missed if the major determinant of benzylpenicillin alone had been used for skin testing. The additional use of the minor determinants of other penicillin derivatives, however, did not increase substantially the clinical reliability of the skin testing procedure.
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PMID:Diagnosis of penicillin allergy by skin testing: the Manitoba experience. 63 9

Among drug exanthemata (AE) are included allergic reactions of the cutaneous system which are of a cutaneous vascular type after hematogenous supply of the allergen, which run an immunological course according to the early, Arthus or late type. They are manifested morphologically as urticaria (monosymptomatic or a partial symptom of an anaphylactic or serum sickness syndrome), as macular or maculopapular exanthema (9 days AE) predominantly after ampicillin, as a fixed AE, as Lyell's disease (fatal in about 30% of cases), as erythema multiforme-like AE, as purpura (allergic vasculitis, "carbromal purpura"), as rare lichenoides or nodose AE and as erythematodes-like drug reactions.
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PMID:[Drug-induced allergic skin reactions of a cutaneous vascular type (author's transl)]. 80 98

A patient with hypocomplementemic urticarial vasculitic syndrome (HUV) is presented. This is an immunological pathology, limited to skin or multisystemic, that requires a differential diagnosis with erythematosus systemic lupus on the same occasions. The ever-present symptom is skin participation, such as urticaria-angioedema or fixed exanthema; biopsy shows necrotizing venulitis with polymorphonuclear infiltration and leukocytoclastic powder. Typical laboratory data are: diminished C3, C4 and C1q; C1 inhibition can be low or normal; the more characteristic finding is the presence of C1q associated immunocomplexes. Leukocytoclastic necrotizing vasculitis was found in the skin biopsy. During the course of illness (three years) the patient presented moderate cutaneous symptoms and asthma, without other systemic participation. During this period, antihistamines and, occasionally, corticoids were administered with improvement. Moreover, the patient presented urticaria related to ampicillin ingestion, and furthermore, the presence of anaphylaxis to beta-lactam was diagnosed in vivo and specific IgE was found in the laboratory study. This feature was previously observed by other authors; however, we cannot determine why the IgE-mediated allergy to beta-lactam and a complement pathology like HUV are related.
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PMID:Hypocomplementemic urticarial vasculitic syndrome, asthma and anaphylactic reaction with ampicillin. 166 67

A total of 754 patients were treated intravenously with sulbactam/ampicillin, in a clinical trial to determine the efficacy and safety of the drug. The majority of patients were treated with 3 g/day by intravenous infusion for 4 to 14 days. Clinical response was evaluated in 689 of 754 patients. In the treatment of respiratory and urinary tract infections, efficacy was 82.5% and 77.1%, respectively. Overall, sulbactam/ampicillin was effective in 80.4% of all evaluable patients. Of 175 patients who failed to respond to prior antibiotic therapy, 135 patients (77.1%) were effectively treated with sulbactam/ampicillin. The overall bacteriological eradication rate was 91.8% against Gram-positive organisms, 75.9% against Gram-negative organisms, and 90% against anaerobes. In addition, 166 of 221 strains that were beta-lactamase producers were eradicated after treatment with sulbactam/ampicillin. Side effects such as rash, fever, itching, urticaria, and diarrhea occurred in only 2.65%, 20 of 754 cases. Laboratory abnormalities were similar to those reported for other beta-lactam antibiotics, including increases in levels of SGOT (4.9%), SGPT (5.7%), and eosinophilia (3.4%) counts. The study showed that sulbactam/ampicillin has a broad spectrum of antibacterial activity against both Gram-positive and Gram-negative organisms as well as anaerobes. There was a high degree of safety. Thus, sulbactam/ampicillin is effective and safe as a treatment for medical, surgical, urological, and gynecological infections.
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PMID:Clinical evaluation of sulbactam/ampicillin in Japan. 268 16

A single-blind, parallel, randomized study comparing the efficacy of furazolidone and ampicillin in the treatment of children with acute invasive diarrhea was conducted among outpatients at the Hospital General de Ciudad Nezahualcoyotl in Mexico between August 1986 and October 1987. Seventy-eight patients were admitted to the study; 39 were randomized to receive furazolidone (5 mg/kg/day for 5 days), and 39 were randomized to receive ampicillin (100 mg/kg/day for 5 days). The enteropathogens Shigella sp, Salmonella sp, and Escherichia coli were isolated in 87.2% of the initial stool cultures. A preliminary assessment of the patients' clinical status was made on day 3. At that time 97.4% of furazolidone patients had improved, compared with 65.7% of patients in the ampicillin group (p = 0.002). At the end of the treatment period (day 6), 100% of evaluable patients treated with furazolidone had a negative stool culture, compared with 71% of evaluable patients treated with ampicillin (p = 0.002). Both absence of watery stools by day 5 and a negative day 6 stool culture determined treatment success. Overall, there was a greater percentage of treatment successes in the furazolidone group than in the ampicillin group (92.3% versus 51.3%, p = 0.001). Tolerance to both drugs was very good. One patient treated with ampicillin developed urticaria, which required discontinuation of treatment; the reaction resolved spontaneously after treatment discontinuation. No adverse reactions were reported in the furazolidone group. The results of this study showed that furazolidone was more effective than ampicillin in the treatment of acute invasive diarrhea. It is suggested that furazolidone should be the treatment of choice for this disease.
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PMID:A comparison of furazolidone and ampicillin in the treatment of invasive diarrhea. 269 44

We analyzed the data on 15,438 consecutive medical inpatients monitored by the Boston Collaborative Drug Surveillance Program from June 1975 to June 1982 to determine the rates of allergic cutaneous reactions to drugs introduced since 1975 and to confirm and extend findings from an earlier study of the preceding 22,227 patients. There were 358 reactions occurring in 347 patients, for an overall reaction rate among patients of 2.2%. Each patient received a mean of eight different drugs. Rashes were attributed to 51 drugs, and 75% of the allergic cutaneous reactions were attributed to antibiotics, blood products, and inhaled mucolytics. Amoxicillin (51.4 reactions per 1000 patients exposed), trimethoprim-sulfamethoxazole (33.8/1000), and ampicillin (33.2/1000) had the highest reaction rates. Drug-specific reaction rates ranged from zero to 51.4 per 1000 and were determined for 180 drugs or drug groups. These results provide physicians with quantitative data that will be helpful in clinical decision making when drug-induced exanthems, urticaria, or generalized pruritus occurs.
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PMID:Drug-induced cutaneous reactions. A report from the Boston Collaborative Drug Surveillance Program on 15,438 consecutive inpatients, 1975 to 1982. 294 76

Most cases of neonatal group B streptococcal disease with early onset have an intrapartum pathogenesis. Attack rates are increased substantially in infants born to mothers with prenatal group B streptococcal colonization and various perinatal risk factors (premature labor, prolonged membrane rupture, or intrapartum fever). In a randomized controlled trial, we studied the effect of selective intrapartum prophylaxis with ampicillin in 160 such high-risk women. In infants born to mothers who received intravenous ampicillin during labor, as compared with controls who received no treatment, neonatal colonization with group B streptococci was present in 8 of 85 (9 percent) versus 40 of 79 (51 percent; P less than 0.001), colonization at multiple (greater than or equal to 3) sites was observed in 3 of 85 (4 percent) versus 24 of 79 (30 percent; P less than 0.001), and bacteremia occurred in none of 85 versus 5 of 79 (6 percent; P = 0.024). The side effects of ampicillin were limited to a single episode of urticaria in a mother who had no history of penicillin allergy. We conclude that intrapartum ampicillin prophylaxis in women with positive prenatal cultures for group B streptococci who have certain perinatal risk factors can prevent early-onset neonatal group B streptococcal disease.
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PMID:Prevention of early-onset neonatal group B streptococcal disease with selective intrapartum chemoprophylaxis. 352 Mar 19


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