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)

Penicillin allergy presents a major obstacle to the successful management of some antepartum infections. We studied 15 pregnant women with histories of penicillin allergy confirmed by positive immediate wheal-and-flare skin tests. Thirteen had syphilis, one listeria sepsis, and one Streptococcus viridans endocarditis. Each patient was desensitized over four to six hours by oral administration of increasing doses of penicillin V. At the completion of the procedure, full-dose parenteral therapy with penicillin G or ampicillin was instituted. No extracutaneous reactions were detected. Five of the subjects (33 per cent) experienced pruritus (three) or urticaria (two), but no interruption of desensitization or therapy was necessary. All clinically apparent maternal infections were cured. The pregnancy complicated by listeriosis aborted in the first trimester. The 11 neonates delivered to date are normal. These results indicate that oral desensitization is an acceptably safe approach to therapy in pregnant women who are allergic to penicillin and have infections that require beta-lactam drugs.
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PMID:Penicillin allergy and desensitization in serious infections during pregnancy. 392 35

Cutaneous reaction by ampicillin, do present themselves with a greater frequency than other penicillin derivates and in general rule they are of the urticaria or exanthematous type. The administration to patients with infective mononucleosis or when it is applied together with allopurinol, the risk of cutaneous reactions is greater. There appears a twenty year old, female patient, who by reason of a febrile reaction with odinofagia, is medicated with ampicillin of 1500 milligrams daily, and this unchains generalized morbilliform exantheme, lightly desquamative-a-sole of the feet, hear skin, and being very showy the edema on face. Besides she presented a diffuse enantema. The clinic examination revealed macropolyadenopathy, hepatomegaly, splenomealy and mesosystolic blast. The laboratory showed 55% lymphocytosis, Turk cells and Downey cells. Erythrocyte sedimenation rate 16-36 mm/hs. Total hemolytic complement 105 U (V. N. 160-260). Hipergammaglobulinemia 2,11 mg/dl. Hypergammaglobulinemia total 2 mg/dl. Fosgefose selceline 204 mU/ml. TGO 120 mU/ml. Cholesterol 115 mg/dl. Hyperuricemic 115 mg/dl. Serology for Epstein-Barr virus: 1:40. The rest of proofs did not reveal data of importance. In the infective mononucleosis are described varied cutaneous manifestations which are fugacious and not very frequent. On the contrary the clinic aspect as the observed one in this case, has more intensive and generalized characteristics. It is considered a toxic phenomena because of the proved absence of sensibility to penicillin derivates. Authors advert on the administration of this drug in indefinite pharyngeal cases.
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PMID:[Ampicillin and infectious mononucleosis. Skin manifestations]. 622 89

Skin testing for penicillin allergy with penicillin G (Pen G), penicilloic acid (PA), and penicilloyl poly-L-lysine (PPL) was performed on 740 subjects, and the results were assessed from epidemiologic and immunologic perspectives. Approximately 95% of these patients had histories of apparent allergic reactions to beta-lactam antibiotics, and 63% were skin-test positive. The prevalence of positive skin tests was related to the time that had elapsed between clinical reactions and skin testing. Ninety-three percent were skin-test positive 7 to 12 mo after reactions, and 22% were positive 10 yr or more after reactions. Patients under 30 yr of age had a prevalence of positive skin tests 1.7-fold higher than older patients. Testing with PPL, PA, and Pen G detected 76.3%, 55.3%, and 57.1% of the positive patients, respectively. Omission of PPL, PA, or Pen G would have led to a failure to detect 25.6%, 7.2%, and 6.2% of the positive patients, respectively. Subjects with skin tests positive to penicillin often reacted to skin tests with other beta-lactam antibiotics; 73% (41 of 56) reacted to ampicillin and 51% (38 of 74) reacted to cephalothin. No serious allergic reactions were provoked by testing. None of the 83 skin test--negative patients treated with beta-lactam antibiotics immediately after testing experienced acute allergic reactions. Two patients developed mild urticaria beginning 3 and 5 days into therapy. One skin test--negative patient experienced urticaria 3 hr after receiving oral penicillin 6 mo after skin testing. This patient's skin-test status immediately before therapy was unknown. These results support the position that testing with PPL, PA, and Pen G is a rapid, safe, and effective method for identifying patients at risk, or not at risk, for allergic reactions to penicillin.
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PMID:Skin testing to detect penicillin allergy. 626 15

Epicutaneous, scratch and intracutaneous tests with various penicillins and their major as well as minor determinants were performed on 495 patients either because they were suspected of having a penicillin allergy, or in order to exclude such allergy, or before starting penicillin treatment, or because they suffered from chronic recurrent urticaria. A positive test reaction occurred in 25%: 44% among those with a history pointing to penicillin allergy and 17.8% among those who were tested before treatment to exclude penicillin allergy. Positive reactions also occurred in 11% of patients with chronic recurrent urticaria, but in practically all instances were clinically without significance. D-Penicillamine (Metalcaptase) and penicilloyl-polysine in the intracutaneous test, penicillin-G-sodium and ampicillin in the epicutaneous test gave the highest incidence of positive reactions.
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PMID:[Clinical significance of positive penicillin test reactions (author's transl)]. 737 27

300 children considered to have had adverse reactions to penicillin were examined. Informed consent was obtained from the parents. Skin tests were conducted by the scratch/prick and intradermal techniques, using benzylpenicilloyl polylysine conjugate and a mixture of minor determinants of penicillin. Specific anti-penicillin IgE antibodies were estimated by the radioallergosorbent test. There was a good correlation between the two methods. The overall frequency of positive tests was 19%. 11 children showed cutaneous reactivity only to the minor determinants mixture. Positive results were found more often in those with accelerated adverse reactions, particularly anaphylaxis, serum sickness, angio-oedema, or urticaria. The validity of penicillin-negative results was confirmed by drug challenge in 56 subjects, only 2 of whom showed a slight skin rash. Of 5 patients with positive tests, inadvertent administration of penicillin produced accelerated urticaria in all. 14 of 42 children with positive tests had lost hypersensitivity to penicillin one year later. In a separate group of 50 children with a history of adverse response to ampicillin, the overall frequency of positive tests was 12%; 38% showed evidence of recent E-B virus infection. It was concluded that penicillin allergy is often overdiagnosed. The diagnosis can be reliably confirmed by skin tests using major and minor determinants of benzylpenicillin and by the radioallergosorbent test; such hypersensitivity is not permanent.
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PMID:Penicillin allergy: anti-penicillin IgE antibodies and immediate hypersensitivity skin reactions employing major and minor determinants of penicillin. 743 56

We assessed 195 subjects with histories of adverse reactions to aminopenicillins, using 1) skin tests with penicilloyl polylysine (PPL), minor determinant mixture (MDM), benzylpenicillin (PG), amoxicillin, and ampicillin (read after 20 min and 48 h); 2) patch tests with PG, amoxicillin, and ampicillin; and 3) RAST for penicilloyls G and V. Oral challenges with ampicillin, amoxicillin, and penicillin V were administered to 34/60 patients reporting maculopapular reactions. Immediate hypersensitivity (IH), in most cases for both penicillin and aminopenicillins, was diagnosed (based on skin tests, RAST, or both) in 35 subjects who had suffered anaphylactic shock, or urticaria, angioedema, or both urticaria and angioedema. Thirty-three of the 60 subjects reporting maculopapular reactions presented delayed intradermal and patch-test positivity, indicating delayed hypersensitivity (DH), for ampicillin and amoxicillin, and three were also positive for PG. Diagnoses were confirmed with oral challenges in 18/33. The remaining 27/60 were negative in all allergologic tests, with oral-challenge confirmation in 16. Our findings highlight the importance of the amino group in DH to aminopenicillins. Moreover, the mean time interval between the last reaction and our tests was significantly (P < 0.01) longer in DH subjects (54.96 months) than in those with IH (18.62 months), suggesting that the time of testing is less important in cases of DH.
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PMID:Evaluation of adverse cutaneous reactions to aminopenicillins with emphasis on those manifested by maculopapular rashes. 760 32

A large group of patients with suspected allergic reactions to beta-lactam antibiotics was evaluated. A detailed clinical history, together with skin tests, RAST (radioallergosorbent test), and controlled challenge tests, was used to establish whether patients allergic to beta-lactam antibiotics had selective immediate allergic responses to amoxicillin (AX) or were cross-reacting with other penicillin derivatives. Skin tests were performed with benzylpenicilloyl-poly-L-lysine (BPO-PLL), benzylpenicilloate, benzylpenicillin (PG), ampicillin (AMP), and AX. RAST for BPO-PLL and AX-PLL was done. When both skin test and RAST for BPO were negative, single-blind, placebo-controlled challenge tests were done to ensure tolerance of PG or sensitivity to AX. A total of 177 patients were diagnosed as allergic to beta-lactam antibiotics. We selected the 54 (30.5%) cases of immediate AX allergy with good tolerance of PG. Anaphylaxis was seen in 37 patients (69%), the other 17 (31%) having urticaria and/or angioedema. All the patients were skin test negative to BPO; 49 of 51 (96%) were also negative to MDM, and 44 of 46 (96%) to PG. Skin tests with AX were positive in 34 (63%) patients. RAST was positive for AX in 22 patients (41%) and to BPO in just 5 (9%). None of the sera with negative RAST for AX were positive to BPO. Challenge tests with AX were performed in 23 subjects (43%) to establish the diagnosis of immediate allergic reaction to AX, and in 15 cases (28%) both skin test and RAST for AX were negative. PG was well tolerated by all 54 patients. We describe the largest group of AX-allergic patients who have tolerated PG reported so far. Diagnosis of these patients can be achieved only if specific AX-related reagents are employed. Further studies are necessary to determine the exact extent of this problem and to improve the efficacy of diagnostic methods.
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PMID:Immediate allergic reactions to amoxicillin. 809 27

In this study, we evaluated the clinical efficacy of cefpodoxime proxetil (CPDX-PR) in otorhinolaryngological infections. The subjects were 205 patients (85 men and 120 women) with various otorhinolaryngological infections, aged from 16 to 81 years (mean 49.2 years): 113 patients had acute infections, 25 patients had chronic infections and 67 patients had acute exacerbation of chronic infections. 1. Clinical evaluation The overall efficacy rate was 75.6%. When classified by disease, the efficacy rate was 84.9%, 60.0%, 65.6% in acute infections, chronic infections and acute exacerbation of chronic infections, respectively. 2. Bacteriological evaluation Frequencies of isolation of different organisms were studied: 49 strains of Staphylococcus aureus, 27 strains of Staphylococcus sp. and 15 strains of Streptococcus sp. were found in the decreasing order of frequencies. Antibacterial activities against S. aureus, Staphylococcus sp. and several other organisms were compared among CPDX-PR, ampicillin, cefaclor, cefteram and norfloxacin: CPDX-PR showed the highest activity. 3. Side effect Mild urticaria was observed in only 1 patient. Abnormal laboratory test results were mild elevation of GOT and GPT in 3 of 43 patients. Based on the above results, we consider that CPDX-PR is useful for treatment of otorhinolaryngological infections.
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PMID:[Clinical evaluation of cefpodoxime proxetil in otorhinolaryngological infections]. 811 75

Data deriving from comprehensive hospital monitoring systems suggest that drug-induced skin effects occur in 2-5% of patients receiving any drug medication. Exanthematous (maculopapular) reaction (75%) and urticaria with/without angioedema (30%) are the most frequent of all cutaneous reactions to drugs. The incidence of cutaneous reactions relates to the quantity of the drugs which is prescribed and consumed worldwide. Thus penicillin, sulfonamides and nonsteroidal antiinflammatory drugs show the highest rate of cutaneous side effects. Drug reactions may be classified as either predictable (e.g. chemotherapy-induced alopecia) or unpredictable. Unpredictable side effects of drugs may be the result of allergic (type I to IV) or non-allergic reactions. Hereditary and acquired enzyme deficiency and variations in metabolic pathway may delay drug metabolism and cause nonallergic, toxic side effects. Such a mechanism is known to occur in patients with a low acetylation rate under hydralazine, INH or sulfonamide treatment. Some immunologic although nonallergic factors may facilitate eruptions in patients with infectious mononucleosis under ampicillin medication and in AIDS patients on co-trimoxazole therapy. When a cutaneous drug reaction is diagnosed, withdrawal of the drug is recommended. In instances in which patients display mild drug eruptions and no alternative therapy is available, the drug may be continued. However, it should be kept in mind that mild morbiliform eruption is often the initial presentation of toxic epidermal necrolysis. In AIDS patients sulfonamides most frequently have been implicated as a risk factor for the development of toxic epidermal necrolysis. In other than type 1 hypersensitivity reactions, skin testing and in vitro tests have low sensitivity and specificity.
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PMID:[Skin and hair]. 866 68

The IgE response, the involvement of the different penicillins available for therapeutic use, and the specificity of the IgE antibodies found in a group of penicillin-allergic subjects from Italy were studied. Thirty subjects with a history of allergic reactions to penicillins were studied. In vivo and in vitro specific IgE antibodies were determined to different penicillin determinants. Fifteen subjects developed anaphylactic responses and the remainder urticaria and angioedema. The drug most frequently involved in the patients' allergic reactions was ampicillin (AMP). The benzylpenicilloyl (BPO) skin test was positive in 16 (53.3%) patients, whereas 23 (76.6%) patients were positive to minor determinant mixture (MDM), benzylpenicillin (PG), AMP, or amoxicillin (AX). When classified according to initial reaction type, most anaphylactic patients (93.3%) were associated with minor determinant reactivity, whereas most urticaria patients (80%) reacted to BPO. RAST results for the anaphylactic and urticaria subgroups were similar. RAST inhibition showed that most sera contained highly cross-reactive IgE antibodies. There was evidence of a specific response to AX and PG (one patient each). These data show that in a population of penicillin-allergic patients from Italy, AMP was the main drug inducing the allergic reaction. In skin tests and RAST, patients exhibited heterogeneous IgE responses with little indication of specific reactivity to AMP.
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PMID:Immediate hypersensitivity to penicillins. Studies on Italian subjects. 906 34


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