Beta-lactam allergy in adults with cystic fibrosis.

Abstract

BACKGROUND:

Allergic reactions to one or more beta-lactam antibiotic can pose a management problem in patients with cystic fibrosis (CF), and may limit antibiotic choice.

METHOD:

The aim of this study was to assess the prevalence of allergy to anti-pseudomonal beta-lactam antibiotics in an adult CF centre and to assess variables, which may contribute to the development of allergic reactions. A questionnaire-based interview and a review of medical records were performed.

RESULTS:

Of the 150 patients, 54 (36%) had allergic reactions to one or more beta-lactam antibiotics and 20 (19%) had allergic reactions to multiple beta-lactam antibiotics. The proportion of patients allergic to specific beta-lactam antibiotics varied from 10% to 26%. Rates of reactions were highest for penicillins and cephalosporins, intermediate for carbepenems and lowest for aztreonam. Of all reactions, 40% occurred within 24 h of the commencement of an individual antibiotic course. Patients with one or more beta-lactam allergic reactions had received greater cumulative exposure (p<0.0001), were older (p=0.016) and had lower lung function (p=0.037) than patients without a history of beta-lactam allergy. Cystic Fibrosis transmembrane regulator (CFTR) status, gender, peripheral blood eosinophil count and total IgE concentrations were not different in patients with allergic reactions.

CONCLUSIONS:

This study demonstrates that the prevalence of allergic reactions to beta-lactam antibiotics is high in adults with CF. Increasing age; cumulative exposure and decreasing FEV(1) were associated with the development of allergy.

• Authors: Judith A Burrows, Lisa M Nissen, Carl M J Kirkpatrick, Scott C Bell
• Journal: Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society (J Cyst Fibros) Vol. 6 Issue 4 Pg. 297-303 (Jul 2007) ISSN: 1569-1993 [Print] Netherlands
• PMID: 17182289 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• beta-Lactams

Topics

• Adolescent
• Adult
• Cystic Fibrosis (drug therapy, physiopathology)
• Drug Hypersensitivity (epidemiology)
• Female
• Forced Expiratory Volume (drug effects, physiology)
• Humans
• Male
• Middle Aged
• Prevalence
• Queensland (epidemiology)
• Retrospective Studies
• Risk Factors
• beta-Lactams (adverse effects, therapeutic use)