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Selective immediate responders to amoxicillin and clavulanic acid tolerate penicillin derivative administration after confirming the diagnosis
Author(s) -
BlancaLopez N.,
PerezAlzate D.,
Ruano F.,
Garcimartin M.,
Torre V.,
Mayorga C.,
Somoza M. L.,
Perkins J.,
Blanca M.,
Canto M. G.,
Torres M. J.
Publication year - 2015
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.12636
Subject(s) - penicillin , provocation test , medicine , amoxicillin , allergy , clavulanic acid , group b , immunology , antibiotics , gastroenterology , pharmacology , microbiology and biotechnology , pathology , biology , alternative medicine
Background An increasing number of patients show immediate selective hypersensitivity reactions to clavulanic acid ( CLV ) and amoxicillin ( AX ), probably due to their increased prescription. The maintenance of this response should be established. Objective To assess that the immediate hypersensitivity selective response to AX or to CLV is maintained after repeated administration of penicillin G ( PG )/penicillin V ( PV ) and AX . Methods Patients with proven immediate hypersensitivity to AX (Group A) or CLV (Group B) were included. Diagnosis was performed using skin tests with major and minor determinants of PG ( PPL / MDM ), AX and CLV and by drug provocation test ( DPT ) if required. Selectivity was established by confirming tolerance to PG / PV (Group A) and to PG / PV and AX (Group B). The maintenance of the selective response was verified by repeating DPT , 15 days after the initial investigation, with the same procedure. Results Of 51 patients, 78% belonged to Group A and 22% to Group B. Most had anaphylaxis. In Group A, 72% were skin test positive; 28% required DPT . In Group B, 63% were skin test positive; 37% required DPT . Only two AX ‐selective cases developed positive responses after re‐provocation with PG / PV . No cases selective for CLV developed a positive response to PG , PV or AX . Discussion The selective response to AX appears consistent, and a response to penicillin determinants only develops in a minority of cases. For the case of CLV , the selective response appears not to be modified by exposure to penicillin determinants, meaning that patients with CLV allergy can take penicillin derivatives safely.