title: Beta-lactam antibiotic sensitization and its relationship to allergic diseases in tertiary hospital nurses.
abstract: OBJECTIVE
  Skin allergies through type 1 and 4 hypersensitivity reactions are the most frequent manifestations of drug allergies. We had previously experienced a case of a nurse with cefotiam-induced contact urticaria syndrome. To aid in preventing the progression of drug-induced allergic disease in nurses, we conducted a survey of tertiary hospital nurses who were likely to have been exposed professionally to antibiotics.
  
  
  METHODS
  All 539 staff nurses at a tertiary hospital were asked to respond to a questionnaire regarding antibiotic exposure. Of the 457 nurses (84.8%) who responded, 427 (79.2%) received a physical examination of the hands and 318 (59.0%) received skin prick tests with the beta-lactam antibiotics cefotiam, cefoperazone, ceftizoxime, flomoxef, piperacillin and penicillin G.
  
  
  RESULTS
  A positive response to at least one of the antibiotics occurred in 8 (2.6%) of the 311 subjects included in the analysis and stages 1 and 2 contact urticaria syndrome were observed in 38 (8.9%) and 3 (0.7%) of 427 nurses, respectively. The frequencies of a positive antibiotic skin test (6.9 versus 1.3%, chi(2)=7.15, P=0.018), stage 1 contact urticaria syndrome (14.4 versus 7.4%, chi(2)=4.33, P=0.038) and drug allergy (15.3 versus 3.6%, chi(2)=18.28, P=0.000) were higher in subjects with a positive skin allergy history than in those without. Allergic rhinitis (P=0.02, OR=3.86, CI=1.23-12.06), night cough (P=0.04, OR=3.12, CI=1.03-9.41) and food allergy (P=0.00, OR=9.90, CI=3.38-29.98) were significant risk factors for drug allergy.
  
  
  CONCLUSIONS
  Antibiotic sensitization and drug allergy occurred more frequently in nurses with a positive skin allergy history. Atopy may be an important risk factor for drug allergy.
authors.affiliation: Allergy Division of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Inseon S
authors.initials: IS
authors.lastname: Choi
authors.forename: Eui-Ryoung
authors.initials: ER
authors.lastname: Han
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Lim
authors.forename: Seong-Ryoon
authors.initials: SR
authors.lastname: Lim
authors.forename: Ji-Na
authors.initials: JN
authors.lastname: Kim
authors.forename: Sin-Young
authors.initials: SY
authors.lastname: Park
authors.forename: Su-Kyoung
authors.initials: SK
authors.lastname: Chae
authors.forename: Hye-Hyeun
authors.initials: HH
authors.lastname: Lim
authors.forename: Young-Ae
authors.initials: YA
authors.lastname: Seol
authors.forename: You-In
authors.initials: YI
authors.lastname: Bae
authors.forename: Young-Ho
authors.initials: YH
authors.lastname: Won