Asthma due to inhaled chemical agents--the macrolide antibiotic Spiramycin

Clinical Allergy
R J Davies, J Pepys


One year after starting work in the pharmaceutical industry a 35-year-old non-atopic maintenance engineer developed attacks of sneezing, coughing and breathlessness. These occurred at home during the evening and early morning, never at work during the day. His employment involved contact with a wide variety of chemical agents including the macrolide antibiotic spiramycin. Inhalation challenge tests carried out in hospital with gradually increasing quantities of spiramycin reproduced his symptoms and led to the development of late asthmatic reactions, during which the FEV1 fell by 25% and the FEV1/FVC ratio by 15%. No change occurred in the single breath CO transfer factor nor were crepitations heard over the lung fields which remained normal on chest X-ray. The patient showed positive immediate skin prick tests to spiramycin and developed blood eosinophilia during the late asthma attacks. Inhalation of sodium cromoglycate either before, or before and hourly after the provocation challenge for 6 hr, failed to prevent the late asthma, although its onset was further delayed. On leaving the pharmaceutical industry the patient's symptoms improved but did not finally clear until his wife, who had worked in a clerical capacity in the ...Continue Reading


Jan 6, 1968·Lancet·J A MacfarlaneJ J Robertson
Dec 8, 1973·British Medical Journal·D H BryantL Lazarus
Dec 1, 1972·Clinical Allergy·J PepysE G Hughes
Jun 1, 1972·Clinical Allergy·J PepysH W Loudon
Sep 1, 1972·Clinical Allergy·J PepysD J Terry
Sep 1, 1971·The American Review of Respiratory Disease·J M Peters, R L Murphy
Feb 15, 1969·British Medical Journal·F E HargreaveJ Pepys
Oct 1, 1968·British Journal of Industrial Medicine·S F McCullagh

❮ Previous
Next ❯


Mar 20, 2002·Current Allergy Reports·B A BaldoN H Pham
Jun 2, 1979·British Medical Journal·M G HarriesA MacAuslan
Dec 1, 1981·Thorax·D J Hendrick, L Fabbri
Mar 3, 1999·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·M KronqvistM van Hage-Hamsten
May 24, 2011·Journal of Allergy·Sara Díaz AnguloPaul Cullinan
Mar 1, 1976·Clinical Allergy·S A Greene, S Freedman
Mar 1, 1979·Clinical Allergy·P S BurgeJ Pepys
Sep 2, 2008·The Journal of Allergy and Clinical Immunology·Harold S Nelson
Dec 7, 2007·Regulatory Toxicology and Pharmacology : RTP·K N Woodward
Mar 10, 1998·Allergy·J M Igea, M Lázaro
Jul 1, 1984·Clinical Allergy·G MoscatoF Candura
Nov 1, 1979·Clinical Allergy·P L PaggiaroG Toma
Apr 22, 2005·Journal of Veterinary Pharmacology and Therapeutics·K N Woodward

❮ Previous
Next ❯

Related Concepts

Related Feeds

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.


This feed focuses in Asthma in which your airways narrow and swell. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.