Enhancing effects of fluorescein on beta-lactam rash. I: High incidence of cefclidin rashes in an ophthalmological volunteer trial.
Disseminated maculopapular eruptions were frequently observed in a volunteer trial of cefclidin's use in ophthalmological and neurological examinations (8/12; 67%) It appeared at 8-12 days (mean +/- SD, 9.6 +/- 1.1 days) from the initiation of the trial and subsided within 1-2 days (mean +/- SD, 1.8 +/- 0.4 days). Patch testing with cefclidin produced a +/- reaction in 1 of 8 cases, and the drug-induced lymphocyte stimulation test (DLST) elicited a positive response (SI: 2.8) in 1 of 8 and a weakly positive response (1.8 < or = SI < 2) in 2 of 8. From these findings, it seems likely that the eruptions may be partially mediated by delayed type hypersensitivity (DTH) reactions to cefclidin. No such eruption was observed in the phase II trial of cefclidin where only 2.8% of 1.122 volunteers developed the eruption. The volunteers were given both fluorescein and oxybuprocain in their eyes to measure ocular tension on days -1, 0, 1, 3, 5, 7, 9, 11, 13 and weeks 3, 5, 7 after the initiation of cefclidin. Fluorescein and/or oxybuprocain may affect cefclidin to induce these abnormal reactions in the volunteers.
Tone
T
T
Kitasato University, School of Medicine, Department of Dermatology, Sagamihara, Japan.
Ikezawa
Z
Z
Nishioka
K
K
Aoki
S
S
Miyata
M
M
D000328:Adult; D002511:Cephalosporins / Q000008:administration & dosage / Q000009:adverse effects*; D004311:Double-Blind Method; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology*; D005452:Fluoresceins / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced; D015994:Incidence; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male
D002511:Cephalosporins; D005452:Fluoresceins; C056494:cefclidin