PENICILLIN ALLERGY - CLINICAL-EXPERIENCE WITH A BATTERY OF SKIN-TEST REAGENTS
PENICILLIN ALLERGY - CLINICAL-EXPERIENCE WITH A BATTERY OF SKIN-TEST REAGENTS
复制标题
DOI：
10.1016/0091-6749(82)90105-1
复制
发表时间：
1982-01-01
影响因子：
14.2
通讯作者：
VANDELLEN, RG
中科院分区：
文献类型：
--
作者：
SOLLEY, GO;GLEICH, GJ;VANDELLEN, RG
患者（778例）接受青霉素皮试。每例患者均有青霉素过敏史。皮试试剂包括：市售青霉素G（PEN G）、氨苄青霉素（AMP）和甲氧西林（METH）的新鲜溶液; 3种药物中每种药物的主要抗原决定簇的聚赖氨酸结合物;以及每种药物的碱性水解产物。共有108例（14%）患者对1种或多种试剂呈阳性反应。某些患者对许多试剂表现出反应性，而另一些患者仅对1种或2种试剂有选择性反应。AMP和METH试剂的添加导致比单独使用PEN G试剂时更多的阳性反应物。在皮试阴性的一组中，290人（43%）后来接受了青霉素治疗，其中12人（4.1%）出现了过敏反应。皮肤试验呈阳性的组中有8人随后接受了治疗，其中4人（50%）再次出现过敏反应。一组151例皮肤试验阴性和27例皮肤试验阳性的患者接受头孢菌素治疗。只有2名患者对该药物有过敏反应;两人对青霉素的皮肤试验均为阴性。如果皮试阴性，随后对青霉素过敏反应的风险明显比阳性低得多，用半合成青霉素进行皮试会增加皮试反应者的数量，用头孢菌素治疗的患者过敏反应的发生率低。
Patients (778) underwent penicillin skin testing. Each patient gave a history of previous penicillin allergy. The skin-test reagents consisted of: fresh solutions of commercially prepared penicillin G (PEN G), ampicillin (AMP) and methicillin (METH); polylysine conjugates of the major antigenic determinants of each of the 3 drugs; and alkaline hydrolysates of each drug. A total of 108 (14%) patients showed positive reactions to 1 or more of the reagents. Certain patients showed reactivity to many reagents, whereas others reacted selectively to only 1 or 2 reagents. Addition of reagents of AMP and METH resulted in a greater number of positive reactors than when reagents of PEN G alone were used. Of the group whose skin tests were negative, 290 (43%) were later treated with a penicillin, 12 of these (4.1%) had allergic reactions. Eight of the group whose skin tests were positive were subsequently treated, and 4 of these (50%) had allergic reactions again. A group of 151 patients whose skin tests were negative and 27 patients whose skin tests were positive were treated with a cephalosporin. Only 2 patients had allergic reactions to the drug; both had had negative skin tests to penicillin. The risk of subsequent allergic reactivity to penicillin is apparently much lower if the skin tests are negative than if positive, that testing with semisynthetic penicillins increases the number of skin-test reactors and that the incidence of allergic reactions is low in patients treated with a cephalosporin.