Antibiotic allergy in systemic lupus erythematosus: a case-control study.
Antibiotic allergy, especially to sulfonamides, has been reported as both a predisposing factor and as an exacerbating agent in systemic lupus erythematosus (SLE). We surveyed 221 members of The Johns Hopkins Lupus Cohort and 2 control groups, consisting of 178 relatives and 186 best friends, for antibiotic allergy to penicillin/cephalosporins, sulfonamides, tetracyclines, and erythromycin. Antibiotic allergy was common in patients with SLE exposed to the drug: 27% penicillin/cephalosporin, 31% sulfonamide, 7% tetracycline, and 13% erythromycin. In all cases, the most common allergic reaction was rash. Worsening of SLE occurred in 21% of sulfonamide allergic reactions. Allergy to penicillin/cephalosporin (OR 2.3, 95% CI 1.5-3.6), sulfonamides (OR 2.4, 95% CI 1.2-4.7) and to erythromycin (OR 4.8, 95% CI 1.5-14.9) was significantly more common in exposed patients with SLE than in exposed controls. Thus, antibiotic allergy is a frequent finding in patients with SLE and, in the case of sulfonamide allergy, can be associated with lupus exacerbation.
Petri
M
M
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Allbritton
J
J
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D015984:Causality; D002511:Cephalosporins / Q000009:adverse effects; D015331:Cohort Studies; D004342:Drug Hypersensitivity / Q000150:complications / Q000209:etiology*; D004917:Erythromycin / Q000009:adverse effects; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000009:adverse effects; D013449:Sulfonamides / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013754:Tetracyclines / Q000009:adverse effects
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D010406:Penicillins; D013449:Sulfonamides; D013754:Tetracyclines; D004917:Erythromycin