Introduction: Beta-lactams (BL) are the main cause of allergic drug reactions mediated by specific immunological mechanisms. Reactions can be IgE or effector T-cell mediated. The new antigenic determinants are recognized by the immunological system in the context of the common beta-lactam structure or the specific differences in the side chains of the antibiotics of this family plus the protein carrier. Areas covered: We have reviewed the recent clinical literature concerning new clinical entities, the progress in diagnosis including the difficulties for in in vivo and or in vitro testing as well as the new algorithms proposed for delabelling subjects classified as allergic to beta-lactams, and recommendations for desensitization procedures. Expert opinion: The knowledge gained over the last years on beta-lactam hypersensitivity has enabled a better understanding and management of cases with allergic reactions to beta-lactams.
Determination of IgE antibodies to the benzyl penicilloyl determinant. A comparison between poly-L-lysine and human serum albumin as carriers
Differences in serum IgE antibody activity to benzylpenicillin and amoxicillin measured by RAST in a group of penicillin allergic patients
Determination of specific IgE antibodies to benzylpenicillin and amoxicillin in sera from patients allergic to beta-lactams
Allergy to penicillin with good tolerance to other penicillins; study of the incidence in subjects allergic to beta-lactams
Studies of the specificities of IgE antibodies found in sera from subjects with allergic reactions to penicillins
Activation and hapten inhibition of mast cells sensitized with monoclonal IgE anti-penicillin antibodies: evidence for two-site recognition of the penicillin derived determinant
Allergic reactions to ampicillin. Studies on the specificity and selectivity in subjects with immediate reactions
Immunologic response to different determinants of benzylpenicillin, amoxicillin, and ampicillin. Comparison between urticaria and anaphylactic shock
Diagnostic evaluation of a large group of patients with immediate allergy to penicillins: the role of skin testing
Clinical evaluation of Pharmacia CAP System RAST FEIA amoxicilloyl and benzylpenicilloyl in patients with penicillin allergy
beta-Lactam allergenic determinants: fine structural recognition of a cross-reacting determinant on benzylpenicillin and cephalothin
Drug provocation testing in the diagnosis of drug hypersensitivity reactions: general considerations
The diagnostic interpretation of basophil activation test in immediate allergic reactions to betalactams
Immediate allergic reactions to cephalosporins: evaluation of cross-reactivity with a panel of penicillins and cephalosporins
IgE antibodies to betalactams: relationship between the triggering hapten and the specificity of the immune response
Relevance of the determination of serum-specific IgE antibodies in the diagnosis of immediate beta-lactam allergy
Continued need of appropriate betalactam-derived skin test reagents for the management of allergy to betalactams
Effects of treatments on the mortality of Stevens-Johnson syndrome and toxic epidermal necrolysis: A retrospective study on patients included in the prospective EuroSCAR Study
Skin testing and drug provocation in the diagnosis of nonimmediate reactions to aminopenicillins in children
Neo-antigens for the serological diagnosis of IgE-mediated drug allergic reactions to antibiotics cephalosporin, carbapenem and monobactam.
Signal Detection of Adverse Drug Reactions of Cephalosporins Using Data from a National Pharmacovigilance Database.
Allergy and Asthma
Allergy and asthma are inflammatory disorders that are triggered by the activation of an allergen-specific regulatory t cell. These t cells become activated when allergens are recognized by allergen-presenting cells. Here is the latest research on allergy and asthma.