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antibiotic allergy
Etiology:
1) type 1 hypersensitivity
2) hypersensitivity to side chains of cephalosporins
- cephalosporins with different side chains do not result in hypersensitivity
Differential diagnosis:
1) idiosyncratic reaction
a) glossitis
b) gastritis
c) abdominal cramps
d) diarrhea
e) dysgeusia
f) nausea/vomiting
2) rash or urticaria
a) may be due to infectious process, not an allergy
b) higher prevalence of skin reactions to penicillins in patients with
1] cystic fibrosis
2] HIV
Complications:
- common & potentially life-threatening skin reactions in HIV patients treated with Bactrim for Pneumocystis carinii
a) early warning signs of erythema or maculopapular rash
b) Stevens-Johnson syndrome may occur if warning signs ignored
Management:
- desensitization if no effective alternative
Related
adverse drug reaction (ADR)
antibiotic therapy
General
type 1 hypersensitivity; immediate hypersensitivity (allergy)
References
Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998