A safe protocol for rapid desensitization in patients with cystic fibrosis and antibiotic hypersensitivity.
BACKGROUND
CF patients often demonstrate hypersensitivity to one or multiple antibiotics due to frequent and repeated exposures. Attempts at antibiotic desensitization in this population are historically complicated by higher reaction rates, failure to complete the procedure and consequent withholding of first-line therapy. This study evaluates the outcomes of a rapid desensitization protocol developed at our institution.


METHODS
We retrospectively reviewed the medical records of 15 patients undergoing 52 rapid antibiotic desensitizations at Brigham and Women's Hospital and Children's Hospital Boston utilizing our protocol.


RESULTS
Mean FEV1 % predicted was 44.1 (SD 16.5), with two patients at <30% and one patient desensitized during bilateral lung transplantation. Adverse reactions during desensitization occurred in 13.4%, and most were mild. 100% of patients completed the protocol and ultimately tolerated subsequent full-strength antibiotic courses.


CONCLUSIONS
CF patients with antibiotic hypersensitivity can safely receive first-line antibiotics via our rapid desensitization protocol, including those with severe obstructive lung disease.
Legere
Henry J
HJ
Brigham and Women's Hospital/Harvard Medical School, Division of Rheumatology, Immunology and Allergy, 75 Francis Street, Boston, MA 02115, USA.
Palis
Ross I
RI
Rodriguez Bouza
Tito
T
Uluer
Ahmet Z
AZ
Castells
Mariana C
MC
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000276:immunology; D001424:Bacterial Infections / Q000188:drug therapy; D003550:Cystic Fibrosis / Q000150:complications*; D003888:Desensitization, Immunologic / Q000379:methods*; D004342:Drug Hypersensitivity / Q000276:immunology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents