Retrospective clinical study of hypersensitivity reactions to aztreonam and six other beta-lactam antibiotics in cystic fibrosis patients receiving multiple treatment courses.
A total of 2,793 courses of treatment with seven beta-lactam antibiotics were administered to 121 cystic fibrosis patients chronically infected with Pseudomonas aeruginosa, and the patients were evaluated with respect to clinical hypersensitivity reactions. Seventy-five patients (62%) experienced 125 reactions, for an overall frequency (based on the number of courses) of 4.5%. Immediate reactions occurred in 34 patients (28.1%) during 53 courses (1.9%). The highest rate of reactions involved piperacillin (50.9% of patients), and the lowest rate involved imipenem and aztreonam (4.0% and 6.5% of patients, respectively); intermediate reaction rates were noted for carbenicillin (23.6% of patients), azlocillin (20.8%), cefsulodin (17.1%), and ceftazidime (13.0%). Cross-reactivity did not appear to be a major problem. Reactions to aztreonam seemed to be restricted to a small group of patients with a high propensity for beta-lactam hypersensitivity.
Koch
C
C
Danish Cystic Fibrosis Center, Copenhagen.
Hjelt
K
K
Pedersen
S S
SS
Jensen
E T
ET
Jensen
T
T
Lanng
S
S
Valerius
N H
NH
Pedersen
M
M
Høiby
N
N
D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001398:Aztreonam / Q000009:adverse effects*; D003550:Cystic Fibrosis / Q000150:complications* / Q000276:immunology; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents; D001398:Aztreonam